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General NPI Number Information
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NPI Number | 1548538168
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Entity Type | Individual
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Provider Name | DENNIS WILSON PHARM.D.
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Gender | Male
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Dates
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Enumeration Date | 12/09/2011
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Last Update Date | 12/09/2011
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Provider Practice Location Address
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Address Line | 1909 E NINE MILE RD
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City | PENSACOLA
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State | FL
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Zip | 32514-7766
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Country | US
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Telephone | 850-471-9065
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Fax | 850-471-9163
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Provider Business Mailing Address
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Address Line | 1909 E NINE MILE RD
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City | PENSACOLA
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State | FL
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Zip | 32514-7766
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Country | US
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Telephone | 850-471-9065
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Fax | 850-471-9163
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PS21925
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 7482
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License Number State | AL
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