Individual
DR. JOHN WILSON III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
212 W ROUTE 38 STE 105, MOORESTOWN, NJ 08057-4100
(856) 600-4011
Mailing address
212 W ROUTE 38 STE 105, MOORESTOWN, NJ 08057-4100
(856) 600-4011
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
25MA10496700
NJ
2084P0800X
Psychiatry Physician
309405
LA
Other
Enumeration date
04/08/2015
Last updated
07/16/2020
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