Individual provider · Type 1 NPI

Marty C. Wilson, PA-C

Surgical Physician Assistant · Springfield, IL

NPI number 1184045338 Active

Practice location

1301 S Koke Mill Rd
Springfield, IL 62711-9252

Call (217) 547-9100 Map

Fax (217) 547-9236

Specialties and licenses

TaxonomyCodeLicense
Surgical Physician Assistant Primary 363AS0400X085004959 (IL)

Surgical Physician Assistant: Definition to come...

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About NPI 1184045338

Marty C. Wilson, PA-C's National Provider Identifier is 1184045338, issued on Dec 13, 2013. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Springfield, IL. The record was last updated on Apr 13, 2020.