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NPI Code Detail

MEDICARE: DR. KATELYNN MARIE WILTON MD, PHD

MEDICARE: DR. KATELYNN MARIE WILTON MD, PHD
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
1207ZP0102XAnatomic Pathology & Clinical Pathology Physician1021549MA
2390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1699351783
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KATELYNN MARIE WILTON MD, PHD
Provider Business Mailing Address
First Line : 876 W VILLAGE CIR SE
Second Line :
City : ROCHESTER
State : MN
Zip : 55904-5109
Country : US
Telephone Number : 315-345-8359
Fax Number :
Provider Business Practice Location Address
First Line : 75 FRANCIS ST
Second Line :
City : BOSTON
State : MA
Zip : 02115-6106
Country : US
Telephone Number : 617-732-7510
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/20/2021
Last Update Date : 12/02/2025

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