Individual
MR. JAMES ROBERT WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
B.S
Contact information
Practice address
1312 N 1ST AVE, DURANT, OK 74701-2810
(580) 920-2069
Mailing address
1312 N 1ST AVE, DURANT, OK 74701-2810
(903) 820-9475
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
02/18/2020
Last updated
02/18/2020
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