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Individual

MR. GARLAND A WILSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
100 LANTANA RD, SUITE 202, CROSSVILLE, TN 38555-1903
(931) 484-5141
(931) 484-5141
Mailing address
100 LANTANA RD, SUITE 202, CROSSVILLE, TN 38555-1903
(931) 484-5141
(931) 484-5620

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD36129
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1689631137
GROUP NPI
TN
01
3373352
UFP MEDICARE GRP
TN
05
3876794
TN
01
4066103
BLUE CROSS
TN
01
P00019568
RAILROAD MEDICARE
Enumeration date
08/10/2006
Last updated
09/28/2012
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