Individual
DR. WILTON DAVID MCRAE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1320 HIGHWAY 231 S, SUITE 3, TROY, AL 36081-3000
(334) 807-8448
(334) 807-6099
Mailing address
1330 HIGHWAY 231 S, TROY, AL 36081-3058
(334) 670-5474
(334) 670-5446
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
6245
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009962705
—
AL
01
—
051512237
BCBS/ENTERPRISE
AL
05
—
051552696
—
AL
01
—
51523327
BLUE CROSS BLUE SHIELD #
AL
01
—
529402450
MEDICAID BILLING GROUP #
AL
Enumeration date
10/31/2005
Last updated
04/03/2017
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