Individual provider · Type 1 NPI
Brett Lee Wilson, PA
Surgical Physician Assistant · Liberty, MO
NPI number
1194726307
Active
Practice location
2521 Glenn Hendren Dr Ste 204
Liberty, MO 64068-3388
Mailing address
1733 County Road 200
Emporia, KS 66801-7672
Other practice locations
- 2522 W 15th Ave, Emporia, KS 66801-6102 · (620) 343-7043
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Surgery Physician | 208600000X | 15-00245 (KS) |
| Surgical Physician Assistant Primary | 363AS0400X | 2009014905 (MO) |
Surgical Physician Assistant: Definition to come...
3 other providers at this address
Other surgical physician assistant providers in Liberty
About NPI 1194726307
Brett Lee Wilson, PA's National Provider Identifier is 1194726307, issued on Aug 10, 2005. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Liberty, MO. The record was last updated on Jun 19, 2019.