DONOVAN DEAN WILSON

BRISTOL, TN
NPI1093743726
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy367500000X Nurse Anesthetist, Certified Registered
(Licence: TX  112090)
Additional Taxonomies367500000X Nurse Anesthetist, Certified Registered
(Licence: TN  37086)
Enumeration Date2006-06-29
Last Update Date2019-05-20
Business Address
DONOVAN DEAN WILSON
1 MEDICAL PARK BLVD
BRISTOL, TN 37620-7430
Phone number: 423-844-1121
Mailing Address
DONOVAN DEAN WILSON
350 BLOUNTVILLE HWY STE 207
BRISTOL, TN 37620-0213
Phone number: 423-968-4540