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1225080732
KEVIN J WILSON
MERIDIAN, ID
NPI
1225080732
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207Q00000X Family Medicine
(Licence: ID M9669)
Enumeration Date
2006-05-16
Last Update Date
2012-08-21
Business Address
Dr. KEVIN J WILSON MD
3140 W MILANO DR SUITE 150
MERIDIAN, ID 83646-7290
Phone number: 208-887-4775
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Mailing Address
Dr. KEVIN J WILSON MD
190 E BANNOCK ST
BOISE, ID 83712-6241
Phone number: 208-887-4775
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