Individual
DR. JOSEPH S WILSON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
755 MOUNT VERNON HWY, 530, ATLANTA, GA 30328-4274
(404) 252-7970
(404) 250-0553
Mailing address
755 MOUNT VERNON HWY, 530, ATLANTA, GA 30328-4274
(404) 252-7970
(404) 250-0553
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
20626
GA
207RI0011X
Interventional Cardiology Physician
20626
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000324959 B, F
—
GA
Enumeration date
08/03/2006
Last updated
11/30/2009
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