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Individual

DR. MICHAEL ANTHONY WILSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
704 POPLAR ST, ALBANY, KY 42602-1520
(931) 510-7057
Mailing address
704 POPLAR ST, ALBANY, KY 42602-1520
(931) 510-7057

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
01065277A
IN
207R00000X
Internal Medicine Physician
0116024840
VA
207R00000X
Internal Medicine Physician
Primary
03758
KY
207R00000X
Internal Medicine Physician
TP949
KY
208M00000X
Hospitalist Physician
03758
KY

Other

Enumeration date
06/18/2012
Last updated
11/25/2019
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