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NPI Code Detail

MEDICARE: JOSHUA M WILSON DC

MEDICARE: JOSHUA M WILSON DC
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
1111N00000XChiropractorCHIR010131GA
2111N00000XChiropractorCH12879FL

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 : 1194295592
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOSHUA M WILSON DC
Provider Business Mailing Address
First Line : 444 SW ALACHUA AVE
Second Line :
City : LAKE CITY
State : FL
Zip : 32025-5213
Country : US
Telephone Number : 386-719-5656
Fax Number : 386-719-5654
Provider Business Practice Location Address
First Line : 444 SW ALACHUA AVENUE
Second Line :
City : LAKE CITY
State : FL
Zip : 32025-5213
Country : US
Telephone Number : 386-719-5656
Fax Number : 386-719-5654
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/28/2018
Last Update Date : 08/21/2019

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Directions to “ JOSHUA M WILSON DC” Practice Location

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