Provider Demographics
NPI:1851397624
Name:WILSON, HAL B (MD)
Entity Type:Individual
Prefix:DR
First Name:HAL
Middle Name:B
Last Name:WILSON
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Gender:M
Credentials:MD
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Mailing Address - Street 1:11000 N SCOTTSDALE RD
Mailing Address - Street 2:SUITE 225
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254-6130
Mailing Address - Country:US
Mailing Address - Phone:602-508-8055
Mailing Address - Fax:602-508-8325
Practice Address - Street 1:11000 N SCOTTSDALE RD
Practice Address - Street 2:SUITE 225
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-6130
Practice Address - Country:US
Practice Address - Phone:602-508-8055
Practice Address - Fax:602-508-8325
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-24
Last Update Date:2014-11-04
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Provider Licenses
StateLicense IDTaxonomies
AZAZ22876207P00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine