National Provider Identifier Database

WANDA G WILSON, DO – NPI #1033182118
General Practice

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.


Contact Information

WANDA G WILSON, DO
3559 AMAZONAS ST
JEFFERSON CITY, MO65109
Phone: 573-893-7848
Fax: 573-893-1984
Website:
Specialty Taxonomy Code
* General Practice 208D00000X

* Indicates primary specialty

NPI Profile & details for WANDA G WILSON

NPI Number 1033182118
Credentials DO (Doctor of Osteopathic)
Entity Individual
Enumeration date 02/09/2006
Last updated 06/30/2009 - About 17 years ago
Sole proprietor1 No
Identifiers
  • MO License #: R8779
  • MO Medicaid: 241488329
  • Other: 185418 BCBS
  • Other: 9183317004 CIGNA
  • Other: 829180 FIRST HEALTH
  • Other: 251463 HEALTHLINK
  • Other: D41738 MERCY
  • Other: P00200365 RR MEDICARE
Hospital affiliation n/a

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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