Individual
DR. REX DUANE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2175 ROSALINE AVE, REDDING, CA 96001-2509
(530) 242-5745
Mailing address
2175 ROSALINE AVE, REDDING, CA 96001-2549
(530) 225-6000
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
G86692
CA
208M00000X
Hospitalist Physician
Primary
G86692
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G866920
—
CA
01
—
124076900
WORKERS COMP PROVIDER #
CA
01
—
G86692
LICENSE NUMBER
CA
Enumeration date
06/13/2005
Last updated
03/07/2023
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