Organization
BRUCE WILSON MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DONALD BRUCE WILSON MD (MD)
(901) 316-1555
Entity
Organization
Contact information
Practice address
5885 AIRLINE RD, # 985, ARLINGTON, TN 38002-5127
(901) 317-7360
(901) 317-7585
Mailing address
5885 AIRLINE RD, # 985, ARLINGTON, TN 38002-5127
(901) 317-7360
(901) 317-7585
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PENDING
MEDICARE
TN
05
—
PENDING
—
TN
Enumeration date
01/29/2015
Last updated
01/29/2015
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