Whalio Doctors

NPI 1033182118

Wanda Gayle Wilson, DO

Practitioner General Practice Physician Jefferson City, MO

Practice location

Address
3559 Amazonas St, Jefferson City, MO 65109
Phone
(573) 893-7848
Fax
(573) 893-1984
Mailing address
3559 Amazonas St Health Branch West, Jefferson City, MO 65109

Registered specialties

General Practice Physician Primary
Allopathic & Osteopathic Physicians Taxonomy 208D00000X Licence R8779 (MO)

Registry record

NPI
1033182118
Entity type
Individual
Sex (as registered)
Female
NPI issued
9 Feb 2006
Record last updated
30 Jun 2009

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.