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Individual

CLAYTON D WILSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1009 N LOCUST AVE, SUITE 1, LAWRENCEBURG, TN 38464-2706
(931) 762-0531
(931) 762-0998
Mailing address
1009 N LOCUST AVE, SUITE 1, LAWRENCEBURG, TN 38464-2706
(931) 762-0531
(931) 762-0998

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
19654
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
PENDING
TN
Enumeration date
09/28/2006
Last updated
04/27/2011
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