Individual
ROBERT JOSEPH WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1855 TANNER WAY, HARRIMAN, TN 37748-8302
(865) 376-6272
(865) 376-0341
Mailing address
1855 TANNER WAY, HARRIMAN, TN 37748-8302
(865) 376-6272
(865) 376-0341
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
30880
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3835683
RAILROAD MEDICARE
TN
05
—
3835683
—
TN
05
—
Q066116
—
TN
Enumeration date
09/02/2005
Last updated
06/25/2021
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