Individual
DOUGLAS R WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3902 25TH ST, COLUMBUS, IN 47203-3007
(812) 375-9390
Mailing address
3902 25TH ST, COLUMBUS, IN 47203-3007
(812) 375-9390
(812) 375-9394
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
01045152
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200091450
—
IN
Enumeration date
08/25/2006
Last updated
01/06/2026
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