Individual
LEI WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPM
Contact information
Practice address
7601 W JEFFERSON BLVD, FORT WAYNE, IN 46804-4133
(260) 436-8686
Mailing address
7601 W JEFFERSON BLVD, FORT WAYNE, IN 46804-4133
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
5951001444
IN
Other
Enumeration date
05/31/2022
Last updated
09/29/2025
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