Individual
SHERRITA COTTON WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3509 FRENCH PARK DR, STE D, EDMOND, OK 73034-7296
(405) 715-4500
Mailing address
3509 FRENCH PARK DR, STE D, EDMOND, OK 73034-7296
(405) 715-4500
Taxonomy
Speciality
Code
Description
License number
State
207ZP0101X
Anatomic Pathology Physician
Primary
19780
OK
207ZP0101X
Anatomic Pathology Physician
L1241
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100746640A
—
OK
01
—
731527740
TAX ID/GROUP MEDICARE
—
Enumeration date
07/21/2006
Last updated
07/09/2007
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