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General NPI Number Information
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NPI Number | 1891772117
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Entity Type | Individual
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Provider Name | MORGAN SCOTT WILSON MD
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Gender | Male
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Dates
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Enumeration Date | 12/28/2005
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Last Update Date | 09/27/2024
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Provider Practice Location Address
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Address Line | 322 VIA LAGUNA VIS
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City | SAN LUIS OBISPO
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State | CA
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Zip | 93405-4763
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Country | US
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Telephone | 805-503-9493
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Fax | 805-439-2186
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Provider Business Mailing Address
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Address Line | 322 VIA LAGUNA VIS
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City | SAN LUIS OBISPO
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State | CA
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Zip | 93405-4763
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Country | US
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Telephone | 805-503-9493
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Fax | 805-439-2186
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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 | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | M-6625
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License Number State | ID
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Taxonomy #2
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | C41439
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License Number State | CA
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