Individual
DR. NATHAN A. WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3485 MIKE PADGETT HWY, AUGUSTA, GA 30906-3815
(706) 771-7843
Mailing address
6531 RIVER BLUFF TRL, MARTINEZ, GA 30907-3317
(706) 831-5834
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
057203
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
597935080A
—
GA
Enumeration date
10/24/2006
Last updated
06/08/2020
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