Individual
DR. MELINDA KAY WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
311 STRAIGHT ST, RADIOLOGY DEPARTMENT, CINCINNATI, OH 45219
(513) 559-2260
(513) 475-5258
Mailing address
1126 S 70TH ST, SUITE N500, MILWAUKEE, WI 53214-3151
(414) 455-4780
(414) 475-2936
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
35064665W
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0917048
—
OH
05
—
100386530
—
IN
05
—
64932288
—
KY
01
—
WI0736415
PTAN
—
Enumeration date
04/05/2006
Last updated
05/27/2008
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