Individual
LLOYD PAUL WILSON
Active
Individual
LLOYD PAUL WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
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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