Individual
MR. PAUL THOMAS WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
230 NORTH RD, LEXINGTON CTR FOR RECOVERY-MMTP, POUGHKEEPSIE, NY 12601-1328
(845) 486-2850
(845) 486-2770
Mailing address
99 HOOF PRINT RD, MILLBROOK, NY 12545-6001
(845) 677-8248
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
002282-1
NY
Other
Enumeration date
07/17/2007
Last updated
07/17/2007
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