Individual
THOMAS WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
201 ANAMARIA DR, RAPID CITY, SD 57701-7305
(605) 503-8192
Mailing address
3531 WILLOWBEND RD, RAPID CITY, SD 57703-6908
(920) 205-1496
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
64846-20
WI
207RC0000X
Cardiovascular Disease Physician
036166996
IL
207RI0011X
Interventional Cardiology Physician
036166996
IL
207RI0011X
Interventional Cardiology Physician
1140094
MT
207RI0011X
Interventional Cardiology Physician
Primary
15475
SD
Other
Enumeration date
02/12/2014
Last updated
09/23/2025
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