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NPI Code Detail

MEDICARE: AARON WILSON

MEDICARE: AARON WILSON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1175T00000XPeer SpecialistOK

General Provider Information

NPI Number : 1508695131
Entity Type Code : Individual
Provider Name (Legal Business Name) : AARON WILSON
Provider Business Mailing Address
First Line : 5729 NW 82ND ST
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73132-4909
Country : US
Telephone Number : 405-920-9310
Fax Number :
Provider Business Practice Location Address
First Line : 220 NW 10TH ST
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73103-3902
Country : US
Telephone Number : 405-627-3371
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/31/2024
Last Update Date : 07/31/2024

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Directions to “ AARON WILSON ” Practice Location

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