MEDICARE: DR. KRISTOPHER CHARLES WILSON MD

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
1	208D00000X	General Practice Physician	25420	NE
2	2083A0100X	Aerospace Medicine Physician	25420	NE
3	171000000X	Military Health Care Provider	25420	NE
4	2083X0100X	Occupational Medicine Physician	25420	NE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2109162460	OTHER	TX	MILITARY

General Provider Information

NPI Number	:	1649431537
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KRISTOPHER CHARLES WILSON MD

Provider Business Mailing Address
First Line	:	PSC 480 BOX 896
Second Line	:
City	:	APO
State	:	AE
Zip	:	09128-0009
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	ARMY HEALTH CLINIC STUTTGART
Second Line	:
City	:	APO
State	:	AE
Zip	:	09128-0009
Country	:	US
Telephone Number	:	314-590-1855
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/23/2008
Last Update Date	:	10/17/2025

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