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Individual

ROBERT EDWARD WILSON JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1250 BEN ALI DR, DANVILLE, KY 40422-8937
(859) 236-0903
(859) 236-7382
Mailing address
PO BOX 990, DANVILLE, KY 40423-0990
(859) 239-2318

Taxonomy

Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
44317
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7100161520
KY
Enumeration date
11/11/2008
Last updated
09/16/2024
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