Individual
RICHARD W WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
999 N CURTIS RD, STE 506, BOISE, ID 83706-1336
(208) 367-2800
(208) 367-2876
Mailing address
999 N CURTIS RD, STE 506, BOISE, ID 83706-1336
(208) 367-2800
(208) 367-2876
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
M3775
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003992400
—
ID
Enumeration date
09/29/2005
Last updated
08/31/2010
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