Individual
DR. JEFFREY KENT WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
8200 MEADOWBRIDGE RD, SUITE 200, MECHANICSVILLE, VA 23116-2331
(804) 730-2121
(804) 730-0563
Mailing address
1115 BOULDERS PKWY, SUITE 200, NORTH CHESTERFIELD, VA 23225-4067
(804) 560-5595
(804) 560-9029
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
101035718
VA
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
101035718
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006403379
—
VA
01
—
052664
ANTHEM HEALTHKEEPERS
VA
01
—
05367828
AETNA HMO
VA
01
—
0900108
UNITED HEALTHCARE
VA
05
—
1215978754
—
VA
01
—
200020605
RAILROAD MEDICARE
VA
01
—
2138346
UNITED HEALTHCARE MAMSI
VA
01
—
285655
SOUTHERN HEALTH
VA
01
—
32147
SH CARENET
VA
01
—
386544
ANTHEM WEST END OPERATORY
VA
01
—
46427
OPTIMA HEALTH
VA
01
—
540885859
CORVEL
VA
Enumeration date
06/08/2006
Last updated
02/19/2015
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