Provider Demographics
NPI:1023241262
Name:WILSON, JOSEPH V
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:V
Last Name:WILSON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:909 E. REPUBLIC RD.
Mailing Address - Street 2:E-200
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65807
Mailing Address - Country:US
Mailing Address - Phone:417-886-1960
Mailing Address - Fax:417-886-2302
Practice Address - Street 1:909 E. REPUBLIC RD.
Practice Address - Street 2:E-200
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65807
Practice Address - Country:US
Practice Address - Phone:417-886-1960
Practice Address - Fax:417-886-2302
Is Sole Proprietor?:No
Enumeration Date:2009-09-03
Last Update Date:2009-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter