Individual
JOHN TRAVIS WILSON
Active
Individual
JOHN TRAVIS WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
MD433645
PA
207RI0011X
Interventional Cardiology Physician
Primary
MD433645
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1027273630001
—
PA
05
—
3810023662
—
WV
Enumeration date
09/25/2007
Last updated
10/05/2020
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