Provider Demographics
NPI:1750381141
Name:WILSON, ELIZABETH A (MD)
Entity type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:A
Last Name:WILSON
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Gender:F
Credentials:MD
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Mailing Address - Street 1:1601 E BROADWAY
Mailing Address - Street 2:WOMEN'S HEALTH ASSOCIATES, INC.
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65201-8020
Mailing Address - Country:US
Mailing Address - Phone:573-443-8796
Mailing Address - Fax:573-875-3949
Practice Address - Street 1:1601 E BROADWAY
Practice Address - Street 2:WOMEN'S HEALTH ASSOCIATES, INC.
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65201-8020
Practice Address - Country:US
Practice Address - Phone:573-443-8796
Practice Address - Fax:573-875-3943
Is Sole Proprietor?:No
Enumeration Date:2005-07-28
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
MO108543207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOH07038Medicare UPIN