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NPI Code Detail

MEDICARE: DR. JOSEPH NATHAN WILSON M.D.

MEDICARE: DR. JOSEPH NATHAN WILSON M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174400000XSpecialistH7849TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1306840947
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOSEPH NATHAN WILSON M.D.
Provider Business Mailing Address
First Line : 301 UTICA AVE
Second Line :
City : LUBBOCK
State : TX
Zip : 79416-3111
Country : US
Telephone Number : 806-797-4985
Fax Number : 806-792-8588
Provider Business Practice Location Address
First Line : 301 UTICA AVE
Second Line :
City : LUBBOCK
State : TX
Zip : 79416-3111
Country : US
Telephone Number : 806-797-4985
Fax Number : 806-792-8588
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/10/2005
Last Update Date : 02/10/2022

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