Individual
MARK E WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
971 LAKELAND DR STE 250, JACKSON, MS 39216-4620
(601) 200-5550
Mailing address
2510 LAKELAND DR, FLOWOOD, MS 39232-9513
(601) 355-1234
(601) 326-3559
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
15570
MS
207RG0100X
Gastroenterology Physician
Primary
15570
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00118644
—
MS
Enumeration date
10/11/2005
Last updated
07/28/2025
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