Individual
DR. JAMES MICHAEL WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, MPH
Contact information
Practice address
800 E DAWSON ST, TYLER, TX 75701-2036
(903) 525-1914
Mailing address
PO BOX 846098, DALLAS, TX 75284-6098
(903) 606-6400
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
7150810-1205
UT
207P00000X
Emergency Medicine Physician
Primary
N8874
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1G4019
MEDICARE
TX
05
—
280231601
—
TX
05
—
280231602
—
TX
01
—
75-0818167-015
TRICARE
TX
01
—
75-0818167-048
TRICARE
TX
01
—
75-2616977-001
TRICARE
TX
01
—
75-2616977-002
TRICARE
TX
01
—
75-2616977-028
TRICARE
TX
01
—
750818167022
TRICARE
TX
01
—
750818167044
TRICARE
TX
01
—
751976930005
TRICARE -JACKSONVILLE
TX
01
—
8CS712
BCBS
TX
01
—
8CT074
BCBS
TX
01
—
8EY087
BCBS
TX
01
—
8X8164
BCBS
TX
01
—
P01439634
RAIL ROAD MEDICARE
TX
Enumeration date
10/07/2008
Last updated
09/27/2023
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