Individual
JULIE ANN WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
112 N 5TH ST, BARNSDALL, OK 74002-6616
(918) 847-2558
Mailing address
1501 W ROGERS BLVD, SKIATOOK, OK 74070-3924
(918) 396-4122
(918) 403-6301
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
3049
OK
Other
Enumeration date
06/11/2019
Last updated
08/28/2019
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