Individual
DR. THOMAS CHARLES WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
1515 DR MARTIN LUTHER KING JR BLVD, MELBOURNE, FL 32901-2946
(321) 723-3500
(321) 723-1945
Mailing address
1515 DR MARTIN LUTHER KING JR BLVD, MELBOURNE, FL 32901-2946
(321) 723-3500
(321) 723-1945
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
PO3765
FL
213ES0103X
Foot & Ankle Surgery Podiatrist
PO3765
FL
213ES0103X
Foot & Ankle Surgery Podiatrist
SC006507
PA
Other
Enumeration date
06/26/2013
Last updated
05/12/2023
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