Organization
CLAYTON D WILSON MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CLAYTON D WILSON MD (MD PRESIDENT)
(931) 762-0531
Entity
Organization
Contact information
Practice address
1009 N LOCUST AVE, SUITE 1, LAWRENCEBURG, TN 38464-2746
(931) 762-0531
(931) 762-0998
Mailing address
1009 N LOCUST AVE, SUITE 1, LAWRENCEBURG, TN 38464-2746
(931) 762-0531
(931) 762-0998
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD19654
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
TN
Enumeration date
11/20/2008
Last updated
01/21/2009
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