Individual provider · Type 1 NPI

Mitchell Reagan Wilson, PA-S

Student in an Organized Health Care Education/Training Program · Springfield, MO

NPI number 1053219170 Active

Practice location

900 N Benton Ave
Springfield, MO 65802-3712

Call (417) 873-7879 Map

Mailing address

6602 E Farm Road 132
Springfield, MO 65802-7268

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1053219170

Mitchell Reagan Wilson, PA-S's National Provider Identifier is 1053219170, issued on Oct 28, 2026. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Springfield, MO. The record was last updated on Oct 28, 2026.