| Doctor Name: | DR. JOHN G WILSON |
| NPI Number: | 1124291612 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | 25MA03369200 |
| Business Practice Address: | 1 S Centre St #201 Merchantville, NJ - 081092213 |
| Business Phone Number: | 8566634447 |
| Business Fax Number: | 8564886380 |
| Mailing Address: | 1 S Centre St, #201 MERCHANTVILLE |
| State: | NJ |
| Postal Code: | 081092213 |
| Phone Number: | 8566634447 |
| Fax Number: | 8564886380 |
| NPI Enumeration Date: | 04/07/2008 |
| NPI Last Update Date: | 04/07/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207VG0400X |
| License Number: | 25MA03369200 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Obstetrics & Gynecology |
| Taxonomy Specialization: | Gynecology |
| Taxonomy Definition: | |