Individual
KAYTON JONATHAN RILEY WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
3501 MILLS AVE, AUSTIN, TX 78731-6309
(512) 324-2036
Mailing address
3501 MILLS AVE, AUSTIN, TX 78731-6309
(512) 324-2036
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
21008
CA
390200000X
Student in an Organized Health Care Education/Training Program
BP10067072
TX
Other
Enumeration date
06/04/2019
Last updated
05/22/2023
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