Individual
LAURIE SUZANNE WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1540 SPRING VALLEY DR, HUNTINGTON, WV 25704-9399
(304) 429-6755
(304) 429-0262
Mailing address
3488 STINSONVILLE RD, MACON, GA 31204-1655
(678) 588-1253
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
29207
WV
Other
Enumeration date
12/16/2008
Last updated
10/10/2019
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