Individual
JOHN ALLEN WILSON JR.
Active
Individual
JOHN ALLEN WILSON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
9300847
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
140007849
RR MEDICARE
—
05
—
211618000
—
WV
01
—
48851
MEDCOST
—
01
—
5514436
AETNA
—
05
—
6100821
—
VA
01
—
6294
PARTNERS
—
05
—
7988337
—
NC
01
—
88337
BCBS
—
05
—
Q00840
—
SC
Enumeration date
01/19/2006
Last updated
08/23/2010
Update your record
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