person
Wanda Gayle Wilson, DO
General Practice Physician in Jefferson City, Missouri
NPI 1033182118

Wanda Gayle Wilson is a General Practice Physician based in Jefferson City, MO. Wanda Gayle Wilson practices in Jefferson City, MO and has the professional credentials of DO. The NPI Number for Wanda Gayle Wilson is 1033182118 and holds a License No. R8779 (Missouri).

The current practice location address for Wanda Gayle Wilson is 3559 Amazonas St, Jefferson City, MO and can be reached out via phone at 573-893-7848 and via fax at 573-893-1984.

Location: 3559 Amazonas St, Jefferson City, MO, 65109
person
Provider Profile Details
NPI Number
1033182118
Provider Name
Wanda Gayle Wilson
Credential
DO
Provider Entity Type
Individual
Gender
Female
Address
3559 Amazonas St, Jefferson City, MO, 65109
Phone Number
573-893-7848
Fax Number
573-893-1984
Provider Enumeration Date
02/09/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
9183317004 01 CIGNA
P00200365 01 RR MEDICARE
185418 01 BCBS
241488329 05 MO
829180 01 FIRST HEALTH
D41738 01 MERCY
251463 01 HEALTHLINK
institution
Provider Business Practice Location Address Details
Address
3559 Amazonas St
City
State
Zip
65109
Phone Number
573-893-7848
Fax Number
573-893-1984
person
Provider Business Mailing Address Details
Address
3559 Amazonas St
City
State
Zip
65109
Phone Number
573-893-7848
Fax Number
573-893-1984
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
General Practice
Speciality
-
Taxonomy
License No.
R8779 (Missouri)
Definition
Definition to come...
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