IndividualActive
Brandon Wilson, PA-C
NPI 1043775414 · Physician Assistant · Kodiak, AK
Provider details
- NPI number
- 1043775414
- Entity type
- Individual
- Primary specialty
- Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- PA-C
- Sex
- Male
- Sole proprietor
- No
- License
- PA01268 (RI)
Practice location
Uscg Base Kodiak Rockmore-King Clinic
200 Albatross Ave Bldg N-46
Kodiak, AK 99615-6810
Phone: (907) 487-5757
Mailing address
37 Cedarwood Ct
Phenix City, AL 36870-4801
Registry dates
- Enumerated
- 2019-02-09
- Last updated
- 2020-08-20
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.