Provider Demographics
NPI:1265469712
Name:WILSON, WILLIAM JOSEPH (PA-C)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:JOSEPH
Last Name:WILSON
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Gender:M
Credentials:PA-C
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Mailing Address - Street 1:18522 HIGHWAY 18
Mailing Address - Street 2:SUITE 102
Mailing Address - City:APPLE VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92307
Mailing Address - Country:US
Mailing Address - Phone:760-242-7709
Mailing Address - Fax:760-242-1133
Practice Address - Street 1:18522 HIGHWAY 18
Practice Address - Street 2:SUITE 102
Practice Address - City:APPLE VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92307
Practice Address - Country:US
Practice Address - Phone:760-242-7707
Practice Address - Fax:760-242-1133
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2015-08-07
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical