NPI 1003644899

Eric Wilson

Practitioner Peer Specialist Lawton, OK

Practice location

Address: 2 SE Lee Blvd, Lawton, OK 73501-2409
Phone: (580) 248-5780
Mailing address: 602 SW 38th St, Lawton, OK 73505-6912

Registered specialties

Peer Specialist Primary

Other Service Providers Taxonomy 175T00000X

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Registry record

NPI: 1003644899
Entity type: Individual
Sex (as registered): Male
NPI issued: 23 Jul 2024
Record last updated: 23 Jul 2024

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.