Thomas L Wilson M D Ltd

NPI #1275597817 in Jacksonville, Illinois

Provider Information

NPI Number: 1275597817
Entity Type: Organization
Organization Name: Thomas L Wilson M D Ltd
Primary Specialty: Urology
Enumeration Date: Apr 12, 2006
Last Updated: Jun 1, 2011

Practice Location

Address: 814 W STATE
City: Jacksonville
State: Illinois
ZIP Code: 62650
Phone: (217) 243-1865

Authorized Official

Name: CHARLES STOTT WILSON, MD
Title: PHYSICIAN
Phone: (217) 243-1865

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Urology	208800000X	Primary

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