Individual
GEORGE GEOFFREY WILSON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
3200 MACCORKLE AVE SE, CHARLESTON, WV 25304-1297
(304) 388-5590
(304) 388-8238
Mailing address
440 PEGRAM DR, TUPELO, MS 38801-6319
(662) 844-5344
(662) 841-0407
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
36822
MS
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/13/2021
Last updated
03/16/2026
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