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Individual

DR. GEORGE P WILSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
4402 GLEN EAGLE DR, COLUMBIA, MO 65203-4834
(573) 443-7893
Mailing address
4402 GLEN EAGLE DR, COLUMBIA, MO 65203-4834
(573) 443-7893

Taxonomy

Speciality
Code
Description
License number
State
207U00000X
Nuclear Medicine Physician
26579
MO
2085R0202X
Diagnostic Radiology Physician
Primary
26579
MO

Other

Enumeration date
02/24/2012
Last updated
02/24/2012
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