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Individual

DR. ROBERT LEWIS WILSON JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
3715 DAUPHIN ST STE 7A, MOBILE, AL 36608-1775
(251) 410-4001
(251) 410-4002
Mailing address
PO BOX 11407 DEPT # 8094, BIRMINGHAM, AL 35246-0001
(251) 410-4001
(251) 410-4002

Taxonomy

Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
23859
TN
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
MD42733
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
3155481
BLUE CROSS PIN
TN
01
3740051
UNITED HEALTHCARE
TN
05
3842696
TN
01
4128772
BCBS
TN
01
611133600
FEDERAL BLACK LUNG
TN
Enumeration date
07/10/2006
Last updated
07/16/2021
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