Individual
DR. G. BARNARD WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1317 OAKDALE RD, STE 620, MODESTO, CA 95355-3365
(209) 524-7870
(209) 524-7985
Mailing address
1317 OAKDALE RD, STE 620, MODESTO, CA 95355-3365
(209) 524-7870
(209) 524-7985
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
5347T
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SDOO53470
—
CA
Enumeration date
06/27/2005
Last updated
02/08/2010
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