Individual
JOSEPH WADE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
22 EXECUTIVE DR, TOMPKINSVILLE, KY 42167-7478
(270) 487-5741
Mailing address
4279 COUNTY HOUSE RD, TOMPKINSVILLE, KY 42167-8401
(270) 427-1133
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2207DT
KY
Other
Enumeration date
10/16/2020
Last updated
05/06/2024
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