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NPI Code Detail

MEDICARE: BRETT WILSON DO

MEDICARE: BRETT WILSON DO
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
1207Q00000XFamily Medicine Physician23305WI

General Provider Information

NPI Number : 1881662963
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRETT WILSON DO
Provider Business Mailing Address
First Line : 1418 JAMESWAY
Second Line :
City : FORT ATKINSON
State : WI
Zip : 53538-2800
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1418 JAMESWAY
Second Line :
City : FORT ATKINSON
State : WI
Zip : 53538-2800
Country : US
Telephone Number : 920-568-0488
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/14/2006
Last Update Date : 01/11/2023

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Directions to “ BRETT WILSON DO” Practice Location

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