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Individual

THOMAS COOPER WILSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
625 6TH AVE S STE 450, ST PETERSBURG, FL 33701
(251) 533-3852
Mailing address
625 6TH AVE S STE 450, ST PETERSBURG, FL 33701-4629
(727) 898-2663
(727) 568-6836

Taxonomy

Speciality
Code
Description
License number
State
207XP3100X
Pediatric Orthopaedic Surgery Physician
10332056-1205
UT
207XP3100X
Pediatric Orthopaedic Surgery Physician
Primary
ME137286
FL

Other

Enumeration date
03/26/2012
Last updated
07/19/2018
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