Individual
DR. JAMES MATTHEW WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
482 HAWTHORNE DR NE, NORTON, VA 24273-2970
(276) 437-3000
Mailing address
PO BOX 9, KINGSPORT, TN 37662-0009
(423) 857-2066
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101250849
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1205981115
—
VA
05
—
71000185520
—
KY
01
—
P01081218
RR MEDICARE
VA
Enumeration date
01/24/2007
Last updated
03/17/2025
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