Individual
DR. ROY A WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
31114 HAGGERTY RD, FARMINGTON HILLS, MI 48331-5803
(248) 788-1610
(248) 788-8290
Mailing address
31114 HAGGERTY RD, FARMINGTON HILLS, MI 48331-5803
(248) 788-1610
(248) 788-8290
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
49010032126
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
459590394
—
MI
05
—
460850086
—
MI
01
—
900F31045
HEALTH ALLIANCE PLAN
MI
01
—
900F368040
BLUE CROSS BLUE SHIELD
MI
Enumeration date
08/02/2006
Last updated
09/10/2008
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