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General NPI Number Information
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NPI Number | 1043311483
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Entity Type | Individual
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Provider Name | JAMES P WILSON M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/26/2006
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Last Update Date | 07/11/2019
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Provider Practice Location Address
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Address Line | 2024 15TH ST FL 2
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City | MERIDIAN
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State | MS
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Zip | 39301
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Country | US
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Telephone | 601-553-2000
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Fax | 601-482-8219
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Provider Business Mailing Address
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Address Line | 2024 15TH ST FL 2
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City | MERIDIAN
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State | MS
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Zip | 39301-4130
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Country | US
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Telephone | 601-553-2000
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Fax | 601-581-1724
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 09663
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License Number State | MS
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