Individual
JOHN ALLAN WILSON IV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1468 MADISON AVE, NEW YORK, NY 10029-6508
(212) 241-6500
Mailing address
1468 MADISON AVE, NEW YORK, NY 10029-6508
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
01097695A
IN
207Y00000X
Otolaryngology Physician
Primary
328916-01
NY
Other
Enumeration date
03/19/2019
Last updated
10/24/2025
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