Individual
STEVEN C. WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
126 W 2ND AVE, WILLIAMSON, WV 25661-3104
(304) 235-2020
(304) 235-8665
Mailing address
126 W 2ND AVE, WILLIAMSON, WV 25661-3104
(304) 235-2020
(304) 235-8665
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
WV758OD
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0149994000
—
WV
01
—
1023416
BRICKSTREET
WV
01
—
1495201
UMWA
WV
01
—
223408
CARELINK
WV
01
—
5003820001
DMERC
WV
01
—
5624220
AETNA
WV
Enumeration date
09/14/2006
Last updated
07/08/2007
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