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Individual

DR. MARK R WILSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
22971 HIGHWAY 76 E, CLINTON, SC 29325-7529
(864) 833-3046
(864) 833-1711
Mailing address
655 W 8TH ST, UF COLLEGE OF MEDICINE - JACKSONVILLE 2ND FLOOR, JACKSONVILLE, FL 32209-6511

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
24897
MS
207X00000X
Orthopaedic Surgery Physician
51989
SC

Other

Enumeration date
04/09/2012
Last updated
12/19/2018
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