Individual
JOHNNY R WILBORN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
100 MEDICAL CENTER DR, #207, GADSDEN, AL 35903-1134
(256) 492-4001
(256) 492-4031
Mailing address
100 MEDICAL CENTER DR, #207, GADSDEN, AL 35903-1134
(256) 492-4001
(256) 492-4031
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
9133
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1558441444 / 109107
—
AL
01
—
515-95241
AL BCBS
AL
Enumeration date
10/16/2006
Last updated
06/23/2009
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