Individual
MR. JAMES E WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
513 NW LAKE WHITNEY PL STE 101, PORT ST LUCIE, FL 34986-1618
(772) 344-7228
(772) 344-7158
Mailing address
513 NW LAKE WHITNEY PL STE 101, PORT ST LUCIE, FL 34986-1618
(772) 344-7228
(772) 344-7158
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA9102360
FL
Other
Enumeration date
06/30/2006
Last updated
11/18/2024
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