Individual
JOSEPH RICHARD WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
610 FLORENCE AVE, OWATONNA, MN 55060-4704
(507) 451-2630
Mailing address
610 FLORENCE AVE, OWATONNA, MN 55060-4704
(507) 451-8807
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
31972
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
105813
UCARE
MN
01
—
15-12382
UNITED BEHAVIORAL HEALTH
MN
05
—
230203900
—
MN
01
—
269000247
MEDICARE PTAN
MN
01
—
69221WI
BLUECROSSBLUESHIELD
MN
01
—
HP18408
HEALTH PARTNERS
MN
Enumeration date
08/31/2006
Last updated
02/10/2021
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