Individual
DR. DOUGLAS GLEN WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
54 HOSPITAL DR, OSAGE BEACH, MO 65065-3050
(573) 348-8000
(573) 348-8309
Mailing address
200 CORPORATE BLVD, LAFAYETTE, LA 70508-3870
(800) 893-9698
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
2014017392
MO
207P00000X
Emergency Medicine Physician
DO.000244
LA
Other
Enumeration date
04/13/2007
Last updated
06/24/2025
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