Individual
KAFI WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1035 RED BUD RD NE, CALHOUN, GA 30701
(706) 879-4776
(706) 879-4781
Mailing address
PO BOX 12938, C/O CLINIC MANAGEMENT, CALHOUN, GA 30701
(706) 602-7800
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
075716
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003178325B
—
GA
05
—
003178325C
—
GA
Enumeration date
07/18/2006
Last updated
12/19/2018
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