Individual provider · Type 1 NPI

Holly Wilson, PHYSICIAN ASSISTANT

Surgical Physician Assistant · Columbia, MO

NPI number 1962707182 Active

Practice location

800 Hospital Dr
Columbia, MO 65201-5275

Mailing address

919 Country Ridge Dr
Jefferson City, MO 65109-5738

Specialties and licenses

TaxonomyCodeLicense
Surgical Physician Assistant Primary 363AS0400X0110002870 (VA)

Surgical Physician Assistant: Definition to come...

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About NPI 1962707182

Holly Wilson, PHYSICIAN ASSISTANT's National Provider Identifier is 1962707182, issued on Jan 19, 2011. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Columbia, MO. The record was last updated on Jan 19, 2011.