Organization
CHARLES E. WILSON, MD, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES ELMO WILSON MD (PRESIDENT)
(256) 718-2188
Entity
Organization
Contact information
Practice address
541 W COLLEGE ST, STE 3500, FLORENCE, AL 35630-5326
(256) 718-2188
(256) 718-3363
Mailing address
541 W COLLEGE ST, STE 3500, FLORENCE, AL 35630-5326
(256) 718-2188
(256) 718-3363
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
15126
MS
208800000X
Urology Physician
Primary
6987
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09016248
—
MS
05
—
09016288
—
MS
01
—
1416173
HIGHMARK BLUE SHIELD
PA
01
—
4042085
BLUE CROSS BLUE SHIELD
TN
05
—
4046425
—
TN
01
—
4661630001
PALMETTO DMERC
—
01
—
51509142
BLUE CROSS BLUE SHIELD
AL
05
—
529912610
—
AL
01
—
DH0160
RAILROAD MEDICARE
AL
01
—
DN0441
RAILROAD MEDICARE
MS
Enumeration date
06/24/2005
Last updated
03/16/2011
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