Individual
DAVID RANDALL WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
150 GILBREATH DR, SUITE 201, ONEONTA, AL 35121-2827
(205) 274-8198
(205) 274-8197
Mailing address
150 GILBREATH DR, SUITE 201, ONEONTA, AL 35121-2827
(205) 274-8198
(205) 274-8197
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
9528
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000085127
—
AL
05
—
541387305
—
AL
Enumeration date
09/27/2006
Last updated
12/16/2010
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