Individual
WILLIAM E WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
315 LANKFORD ST, CLAY CITY, IN 47841-1008
(812) 939-2126
(812) 939-3414
Mailing address
PO BOX 2505, INDIANAPOLIS, IN 46206-2505
(812) 238-7783
(812) 238-4506
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01043986
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100369360
—
IN
01
—
P00213807
RR MEDICARE
IN
Enumeration date
11/04/2005
Last updated
10/18/2010
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