Individual
MR. KERRY THOMAS WILSON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
100 MALLARD CREEK RD, LOUISVILLE, KY 40207-4194
(502) 894-2484
Mailing address
2303 MANCHESTER RD, LOUISVILLE, KY 40205-3045
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4060823
KY
Other
Enumeration date
07/23/2026
Last updated
07/23/2026
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