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Individual

MR. JAMES MICHAEL WILSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
R.PH.

Contact information

Practice address
121 E 4TH ST, OCILLA, GA 31774-1542
(229) 468-5929
(229) 468-7313
Mailing address
371 MCCRANIE RD, OCILLA, GA 31774-2713
(229) 468-5929
(229) 468-7313

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH01000
GA

Other

Enumeration date
01/11/2007
Last updated
07/08/2007
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