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General NPI Number Information
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NPI Number | 1386271161
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Entity Type | Individual
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Provider Name | ERIC CHRISTOPHER WILSON MD
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Gender | Male
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Dates
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Enumeration Date | 03/24/2020
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Last Update Date | 12/05/2025
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Provider Practice Location Address
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Address Line | 720 W OAK ST STE 201
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City | KISSIMMEE
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State | FL
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Zip | 34741-4998
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Country | US
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Telephone | 407-518-3347
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Fax |
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Provider Business Mailing Address
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Address Line | 7574 FORREST SHADOW LN
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City | BARTLETT
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State | TN
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Zip | 38002-7502
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Country | US
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Telephone | 407-774-5506
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Fax |
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 33286
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License Number State | MS
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 71067
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License Number State | TN
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