Kenneth M. Wilson, M.d., P.c.

NPI #1245662410 in Salem, Oregon

Provider Information

NPI Number: 1245662410
Entity Type: Organization
Organization Name: Kenneth M. Wilson, M.d., P.c.
Primary Specialty: Specialist
Enumeration Date: Jul 30, 2013
Last Updated: Jul 30, 2013

Practice Location

Address: 700 BELLEVUE ST SE STE 260
City: Salem
State: Oregon
ZIP Code: 97301-3888
Phone: (503) 375-3636

Authorized Official

Name: DR. KENNETH MITCHELL WILSON, M.D.
Title: PRESIDENT
Phone: (936) 777-2255

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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