MR. Evan Jonathan Wilson, IDC

NPI #1003298571 in Yuma, Arizona

Provider Information

NPI Number: 1003298571
Entity Type: Individual
Name: MR. Evan Jonathan Wilson, IDC
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Military Health Care Provider - Independent Duty Corpsman
Credential: IDC
Enumeration Date: Jun 22, 2015
Last Updated: Sep 16, 2015

Practice Location

Address: 2989 EAST AROW ST
City: Yuma
State: Arizona
ZIP Code: 85365
Phone: (310) 408-7127

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Military Health Care Provider - Independent Duty Corpsman — Independent Duty Corpsman	1710I1002X	Primary

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