Individual
MR. JARED PAUL WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
7070 E DRIVE NORTH, BATTLE CREEK, MI 49014-8562
(269) 660-1670
(269) 660-0666
Mailing address
7070 E DRIVE NORTH, BATTLE CREEK, MI 49014-8562
(269) 660-1670
(269) 660-0666
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601004216
MI
363AS0400X
Surgical Physician Assistant
5601004216
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5601004216
LICENSE, MICHIGAN
MI
Enumeration date
09/30/2006
Last updated
03/07/2023
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