Individual
DR. JONATHAN EDWARD WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
112 NW HACKBERRY ST, LEES SUMMIT, MO 64064-1476
(816) 944-8464
Mailing address
112 NW HACKBERRY ST, LEES SUMMIT, MO 64064-1476
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
2008006047
MO
Other
Enumeration date
07/16/2007
Last updated
10/16/2025
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