Individual
DR. JOHN KEENAN WILSON
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
300 W HOSPITAL RD, BUILDING 300, FORT GORDON, GA 30905-5741
(706) 787-6945
Mailing address
511 AUMOND RD, AUGUSTA, GA 30909-3305
(706) 737-6062
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01055539A
IN
Other
Enumeration date
07/18/2005
Last updated
07/08/2007
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