Individual
LLOYD PAUL WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1200 HILYARD ST STE 410, EUGENE, OR 97401-8158
(541) 681-8586
(541) 681-8587
Mailing address
PO BOX 53, EUGENE, OR 97440
(541) 687-7134
(541) 687-7135
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
MD11715
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
260828
—
OR
01
—
8004138-01
BCBS
OR
01
—
8005089-09
BCBS
OR
05
—
8296717
—
WA
05
—
MD5435R
—
AK
05
—
MD5436R
—
AK
Enumeration date
07/13/2006
Last updated
05/14/2008
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