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General NPI Number Information
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NPI Number | 1407982200
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Entity Type | Individual
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Provider Name | WILSON PRAKASH PAIS MD
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Gender | Male
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Dates
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Enumeration Date | 02/26/2007
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Last Update Date | 08/12/2025
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Provider Practice Location Address
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Address Line | ONE HOSPITAL DR
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City | COLUMBIA
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State | MO
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Zip | 65212-0001
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Country | US
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Telephone | 573-884-8445
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Fax | 573-884-5318
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Provider Business Mailing Address
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Address Line | 135 PLAZA DR STE 102
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City | SIKESTON
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State | MO
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Zip | 63801-5148
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Country | US
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Telephone | 573-472-6010
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Fax | 573-472-6009
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 2007012297
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License Number State | MO
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