Individual
JAMES MILLER WILSON V
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3280 E LANARK DR, MERIDIAN, ID 83642-5982
(208) 377-4400
(208) 377-4416
Mailing address
PO BOX 191050, BOISE, ID 83719-1050
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
M-16498
ID
Other
Enumeration date
03/10/2011
Last updated
08/10/2022
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