Individual
GREGORY A WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
705 RILEY HOSPITAL DR, RI 1601, INDIANAPOLIS, IN 46202-5109
(317) 944-4842
(317) 948-0126
Mailing address
PO BOX 1026, INDIANAPOLIS, IN 46206-1026
(317) 274-1201
(317) 278-9905
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
01027271A
IN
2080P0006X
Developmental - Behavioral Pediatrics Physician
01027271
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100062460
—
IN
05
—
64879984
—
KY
Enumeration date
05/10/2006
Last updated
02/25/2011
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