Individual
TIMOTHY M. WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
17831
SC
207LP2900X
Pain Medicine (Anesthesiology) Physician
17831
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
178319
—
SC
Enumeration date
03/23/2006
Last updated
06/14/2022
Update your record
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