Individual
CHARLES V. WILSON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3525A US HIGHWAY 17, FLEMING ISLAND, FL 32003-7122
(904) 215-3880
(904) 215-3883
Mailing address
3525A US HIGHWAY 17, FLEMING ISLAND, FL 32003-7122
(904) 215-3880
(904) 215-3883
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
AW 1670757
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
065705100
—
FL
Enumeration date
06/26/2006
Last updated
11/09/2009
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