# JOSEPH L WILSON MD INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1730287707
- **Authorized official:** JOSEPH L WILSON M.D. (PRESIDENT)
- **Authorized official phone:** (601) 636-0097

## Contact information

- **Practice address:** 1901 MISSION 66, VICKSBURG, MS 39180-3711
- **Practice address phone:** (601) 636-0097
- **Practice address fax:** (601) 629-9969
- **Mailing address:** 1901 MISSION 66, VICKSBURG, MS 39180-3711
- **Mailing address phone:** (601) 636-0097
- **Mailing address fax:** (601) 629-9969

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | 10040 | MS | Yes |

## Other

- **Enumeration date:** 09/21/2006
- **Last updated:** 08/22/2020