Provider Demographics
NPI:1467791392
Name:WILSON, JUSTIN DEAN (MD)
Entity Type:Individual
Prefix:DR
First Name:JUSTIN
Middle Name:DEAN
Last Name:WILSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:850 E HARVARD AVE STE 505
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80210-5078
Mailing Address - Country:US
Mailing Address - Phone:303-744-1961
Mailing Address - Fax:303-744-1154
Practice Address - Street 1:9980 PARK MEADOWS DR STE 200
Practice Address - Street 2:
Practice Address - City:LONE TREE
Practice Address - State:CO
Practice Address - Zip Code:80124-8406
Practice Address - Country:US
Practice Address - Phone:303-744-1961
Practice Address - Fax:303-744-1154
Is Sole Proprietor?:No
Enumeration Date:2013-02-13
Last Update Date:2024-04-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CO0071454207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology