Individual
DR. GEORGE RICE WILSON III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
655 W 8TH ST, UFJP CHFM - 4TH FLOOR ACC, JACKSONVILLE, FL 32209-6511
(904) 244-5121
Mailing address
PO BOX 44008, UFJP COMMUNITY HEALTH FAMILY MEDICINE, JACKSONVILLE, FL 32231-4008
(904) 244-5121
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
ME25946
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02014
BLUE CROSS BLUE SHIELD
FL
Enumeration date
12/05/2005
Last updated
09/06/2007
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