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General NPI Number Information
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NPI Number | 1770592727
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Entity Type | Individual
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Provider Name | DAVID S WILSON MD
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Gender | Male
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Dates
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Enumeration Date | 08/07/2006
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Last Update Date | 12/18/2020
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Provider Practice Location Address
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Address Line | 225 S PINE ST STE 120
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City | SEYMOUR
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State | IN
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Zip | 47274-2377
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Country | US
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Telephone | 812-524-3328
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Fax | 812-524-3326
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Provider Business Mailing Address
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Address Line | 225 S PINE ST STE 120
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City | SEYMOUR
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State | IN
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Zip | 47274-2377
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Country | US
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Telephone | 812-524-3328
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Fax | 812-524-3326
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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 | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | 01036894
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 01036894
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License Number State | IN
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