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Individual

DR. PAUL KENT WILSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
110 BERMUDA DR, JONESBOROUGH, TN 37659-3166
(515) 537-7592
(888) 645-7299
Mailing address
110 BERMUDA DR, JONESBOROUGH, TN 37659-3166
(515) 537-7592
(888) 645-7299

Taxonomy

Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
732
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0103301077
VIRGINIA PODIATRY LICENSE
VA
01
732
TENNEESEE PODIATRY LICENSE
TN
Enumeration date
07/21/2009
Last updated
06/09/2023
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