Individual
DR. DIANNE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
800 ROSE ST, LEXINGTON, KY 40536-0001
(859) 323-5425
Mailing address
2333 ALUMNI PARK PLZ, SUITE 200, LEXINGTON, KY 40517-4012
(859) 257-7910
Taxonomy
Speciality
Code
Description
License number
State
207ZP0101X
Anatomic Pathology Physician
Primary
19575
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64195753
—
KY
Enumeration date
04/21/2006
Last updated
04/17/2008
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