person
Jerome Laurence Wilson, PA-C
Surgical Physician Assistant in Dyer, Indiana
NPI 1588765010

Jerome Laurence Wilson is a Surgical Physician Assistant based in Detroit, IN and is specialized in Surgical. Jerome Laurence Wilson practices in Dyer, IN and has the professional credentials of PA-C. The NPI Number for Jerome Laurence Wilson is 1588765010 and holds a License No. 085001943 (Indiana).

The current practice location address for Jerome Laurence Wilson is 919 Main St Ste 101, Dyer, IN and can be reached out via phone at 219-836-7531 and via fax at 219-836-7593.

Location: 919 Main St Ste 101, Dyer, IN, 48278-1076
person
Provider Profile Details
NPI Number
1588765010
Provider Name
Jerome Laurence Wilson
Credential
PA-C
Provider Entity Type
Individual
Gender
Male
Address
919 Main St Ste 101, Dyer, IN, 48278-1076
Phone Number
219-836-7531
Fax Number
219-836-7593
Provider Enumeration Date
09/26/2006
Last Update Date
03/08/2024
institution
Provider Business Practice Location Address Details
Address
919 Main St Ste 101
City
State
Zip
46311-3717
Phone Number
219-836-7531
Fax Number
219-836-7593
person
Provider Business Mailing Address Details
Address
919 Main St Ste 101
City
State
Zip
46311-3717
Phone Number
219-836-7531
Fax Number
219-836-7593
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Surgical
Taxonomy
License No.
085001943 (Illinois)
Definition
Definition to come...
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