Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0106X | Orthopaedic Hand Surgeon | MD.43191 | AL |
NPI | 1184010076 |
---|---|
Provider Name | Margaret Rose Wilson |
First Address | Jasper, AL 35501-6117 |
Second Address | Jasper, AL 35501-6117 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/04/2015 |
Last Update Date | 01/02/2022 |