Individual
WILLIAM DRAYTON WILSON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
TAYLOR AT MARION ST, COLUMBIA, SC 29220-0001
(803) 296-5579
(803) 296-5578
Mailing address
PO BOX 402145, ATLANTA, GA 30384-2145
(803) 296-7305
(803) 296-7330
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
12953
SC
208000000X
Pediatrics Physician
12953
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
129532
—
SC
Enumeration date
05/25/2006
Last updated
09/28/2010
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