Individual
DR. LARRY FLICK WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
FAA, ACE-300, 901 LOCUST STREET, RM 350, KANSAS CITY, MO 64106
(816) 329-3250
Mailing address
180 ROCKBRIDGE PARKWAY, EXCELSIOR SPRINGS, MO 64024
(816) 630-0771
Taxonomy
Speciality
Code
Description
License number
State
2083A0100X
Aerospace Medicine Physician
Primary
12735
NE
Other
Enumeration date
11/24/2006
Last updated
07/08/2007
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