Individual
JOHN STEPHEN WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2880 DAUPHIN ST, MOBILE, AL 36606-2457
(251) 473-1900
(251) 470-8943
Mailing address
2880 DAUPHIN ST, MOBILE, AL 36606-2457
(251) 473-1900
(251) 470-8943
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
00014942
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4122373
AETNA PROVIDER #
AL
01
—
51034513
BLUE CROSS PROVIDER #
AL
01
—
51512116
BLUE CROSS AL PROVIDER #
AL
01
—
51536659
BLUE CROSS AL PROVIDER #
AL
01
—
D42385
HEALTHSPRING PROVIDER #
AL
Enumeration date
09/14/2005
Last updated
11/20/2007
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