KENNETH M. WILSON, M.D., P.C.
Medical Practice at Bellevue St, Salem, OR

License number
Oregon MD16217
Category
Medical Practice
Type
Specialist
Owner
Name: DR. KENNETH MITCHELL WILSON M.D.
Title: PRESIDENT
Phone: (936) 777-2255
Address
Address 2
700 Bellevue St SE STE 260, Salem, OR 97301
PO Box 1168, Barlow, OR 97013
National Provider ID: 1245662410
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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KENNETH M. WILSON, M.D., PC

Barlow, OR  -  Salem, OR

Registration:
Nov 6, 1995
Addresses:
PO Box 1168, Canby, OR 97013 (Mailing)
700 Bellevue St SE SUITE 260, Salem, OR 97301 (Physical)
State ID:
48566780
Business type:
DOMESTIC PROFESSIONAL CORPORATION
Agent:
Kenneth Mwilson,700 Bellevue St SE SUITE 260, Salem, OR 97301 (Physical)

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