Individual
DR. KIM JANET WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
415 6TH ST, LEWISTON, ID 83501-2431
(208) 746-0516
(208) 746-4989
Mailing address
3464 ELKS DR, LEWISTON, ID 83501-8630
(208) 798-0562
(208) 746-4989
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
M-6746
ID
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
MD00032548
WA
Other
Enumeration date
12/28/2005
Last updated
10/05/2007
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