Individual
JOHN WELLS WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
188 HOSPITAL DR STE 205, FAIRHOPE, AL 36532-2038
(251) 990-9191
(251) 990-9189
Mailing address
P.O. BOX 1105, FAIRHOPE, AL 36533
(251) 990-9191
(251) 990-9189
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
25140
AL
208600000X
Surgery Physician
12762
MS
208600000X
Surgery Physician
Primary
25140
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00016861
—
MS
05
—
009911601
—
AL
Enumeration date
10/05/2006
Last updated
05/17/2022
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