Individual
DR. MATTHEW W WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
930 MADISON AVE STE 200, MEMPHIS, TN 38103-3452
(901) 448-6650
(901) 302-2486
Mailing address
1068 CRESTHAVEN RD STE 300, MEMPHIS, TN 38119-0809
(901) 866-8864
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
31289
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00120854
—
MS
05
—
003180582A
—
GA
05
—
1104883701
—
KY
05
—
1104883701
—
MO
05
—
138964001
—
AR
05
—
180054
—
AL
05
—
Q003849
—
TN
Enumeration date
04/27/2006
Last updated
02/21/2025
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