IndividualActive
Thomas Wilson, MD
NPI 1689788655 · Diagnostic Radiology Physician · Jackson, WY
Provider details
- NPI number
- 1689788655
- Entity type
- Individual
- Primary specialty
- Diagnostic Radiology PhysicianAllopathic & Osteopathic Physicians
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- License
- 5596A (WY)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
625 East Broadway
St Johns Medical Center Dept of Radiology
Jackson, WY 83001
Phone: (800) 633-1905
Fax: (913) 491-0411
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 9230
Jackson, WY 83002-9230
Registry dates
- Enumerated
- 2006-08-18
- Last updated
- 2023-03-07
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.