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Contact Information

HALLIE J WILSON, DO
114 N MAIN ST
ITHACA, MI48847
 Phone: 989-875-4166
 Fax: 989-875-3600
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family Medicine

207Q00000X 08 Physician/Family Practice
Indicates primary specialty

NPI Profile & details for HALLIE J WILSON · (Female)

NPI Number 1003881053
Status Active
Credentials DO (Doctor of Osteopathic)
Entity Individual
Enumeration date 02/22/2006
Last updated 07/08/2007 - About 19 years ago
Sole proprietor 1 No
Identifiers
  • MI License # 5101011981
  • MI Medicaid 3381288
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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