Individual
JOHN THOMAS WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1040 GULF BREEZE PKWY, GULF BREEZE, FL 32561-7809
(448) 227-7200
Mailing address
1040 GULF BREEZE PKWY STE 100, GULF BREEZE, FL 32561-7808
(448) 227-7200
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
73192
TN
207X00000X
Orthopaedic Surgery Physician
Primary
ME180914
FL
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
ME180914
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/31/2020
Last updated
07/15/2026
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