Individual
D DOUGLAS WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1924 ALCOA HWY, KNOXVILLE, TN 37920-6999
(865) 544-9080
(865) 544-6866
Mailing address
1924 ALCOA HWY, KNOXVILLE, TN 37920-6999
(865) 544-9080
(865) 544-6866
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
08790
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0046502
BCBS OF TN
TN
01
—
220015565
RAILROAD MEDICARE
TN
05
—
3041932
—
TN
Enumeration date
03/21/2006
Last updated
11/18/2010
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