Individual
JOHN AARON WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3001 DAGGETT AVE, KLAMATH FALLS, OR 97601-1114
(541) 851-4800
(541) 851-4801
Mailing address
PO BOX 5074, SIOUX FALLS, SD 57117-5074
(605) 328-6585
(605) 328-6512
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
12729
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
227017
—
OR
01
—
XPY183281
MEDICAL OF CALIFORNIA
CA
Enumeration date
10/13/2006
Last updated
07/03/2013
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