Individual
MR. GEORGE DEAN WILSON JR.
Active
Individual
MR. GEORGE DEAN WILSON JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
MD011166
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0118991
BCBS
TN
01
—
0140000775
CIGNA
—
01
—
1292658
UMWA
—
01
—
130014480
RR MEDICARE
TN
01
—
164888600
OWCP GROUP ID
TN
05
—
3168835
—
TN
01
—
602005579
PHP CARITEN
—
05
—
6196853
—
VA
05
—
64796980
—
KY
05
—
7906816
—
NC
01
—
A55508
JOHN DEERE
—
Enumeration date
05/23/2006
Last updated
03/03/2009
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