Individual
DR. JAMES A WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
425 N COBB ST, MILLEDGEVILLE, GA 31061-2634
(478) 454-1034
(478) 454-1114
Mailing address
425 N COBB ST, MILLEDGEVILLE, GA 31061-2683
(478) 454-1034
(478) 454-1114
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
054702
GA
2084N0600X
Clinical Neurophysiology Physician
054702
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
054702
GEORGIA LICENSE
GA
05
—
357412106A
—
GA
01
—
932114
BCBS OF GEORGIA
GA
01
—
P00292646
RAILROAD MEDICARE
GA
Enumeration date
11/30/2006
Last updated
03/07/2023
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