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General NPI Number Information
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NPI Number | 1952708786
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Entity Type | Organization
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Legal Business Name | DR. PAUL WILSON, INC
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Dates
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Enumeration Date | 11/21/2014
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Last Update Date | 11/21/2014
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Provider Practice Location Address
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Address Line | 440 S REYNOLDS RD STE B
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City | TOLEDO
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State | OH
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Zip | 43615-5900
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Country | US
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Telephone | 419-386-9555
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 8440
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City | TOLEDO
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State | OH
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Zip | 43623-0440
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Country | US
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Telephone | 419-885-0200
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. PAUL W WILSON
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Credential | MD
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Telephone | 419-386-9555
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QA0505X
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Taxonomy Name | Adult Medicine Physician
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License Number | 34002939W
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License Number State | OH
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