Individual
WOODIE J WILSON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
415 S 28TH AVE, HATTIESBURG, MS 39401-7246
(601) 268-5888
(601) 261-3587
Mailing address
415 S 28TH AVE, HATTIESBURG, MS 39401-7246
(601) 268-5888
(601) 579-5240
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
19297
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06207340
—
MS
Enumeration date
08/19/2006
Last updated
07/22/2020
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