Individual
JILL A WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
7910 E WASHINGTON ST, SUITE 300, INDIANAPOLIS, IN 46219-6803
(317) 355-9220
(317) 355-9230
Mailing address
6626 E 75TH ST, SUITE 500, INDIANAPOLIS, IN 46250-2805
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
01055866A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00000846714
ANTHEM
IN
05
—
200390770
—
IN
01
—
P01291667
RAILROAD MEDICARE
IN
Enumeration date
06/30/2006
Last updated
11/27/2023
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