Individual
DR. JASON A WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2015 RANDOLPH RD, SUITE 208, CHARLOTTE, NC 28207-1128
(704) 377-4009
Mailing address
PO BOX 497, HUNTERSVILLE, NC 28070-0497
(704) 377-4009
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2009-0494
NC
207RG0100X
Gastroenterology Physician
Primary
2009-00494
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5913938
—
NC
Enumeration date
10/14/2006
Last updated
06/17/2025
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