| Jacqueline S. Wilson, M.d., P.c. | |
|
321 E Main St Suite 309 Bozeman MT 59715-6241 | |
| (406) 586-7515 | |
| (406) 522-0481 |
| Full Name | Jacqueline S. Wilson, M.d., P.c. |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 321 E Main St, Bozeman, Montana |
| Authorized Official Name and Position | Jacqueline S. Wilson (PRESIDENT) |
| Authorized Official Contact | 4065867515 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jacqueline S. Wilson, M.d., P.c. 321 E Main St Suite 309 Bozeman MT 59715-6241 Ph: (406) 586-7515 | Jacqueline S. Wilson, M.d., P.c. 321 E Main St Suite 309 Bozeman MT 59715-6241 Ph: (406) 586-7515 |
| NPI Number | 1194822049 |
|---|---|
| Provider Enumeration Date | 09/20/2006 |
| Last Update Date | 03/17/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194822049 | NPI | - | NPPES |
| 93296 | Other | MT | BCBS |
| 0152425 | Medicaid | MT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | 8315 (Montana) | Primary |
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