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NPI Code Detail

MEDICARE: WILSON MEDICAL CENTER, INC.

MEDICARE: WILSON MEDICAL CENTER, INC.
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
1207Y00000XOtolaryngology Physician

General Provider Information

NPI Number : 1508097478
Entity Type Code : Organization
Provider Name (Legal Business Name) : WILSON MEDICAL CENTER, INC.
Provider Business Mailing Address
First Line : 1700 TARBORO ST W
Second Line : SUITE 100
City : WILSON
State : NC
Zip : 27893-3481
Country : US
Telephone Number : 252-399-5300
Fax Number : 252-399-5301
Provider Business Practice Location Address
First Line : 1700 TARBORO ST W
Second Line : SUITE 100
City : WILSON
State : NC
Zip : 27893-3481
Country : US
Telephone Number : 252-399-5300
Fax Number : 252-399-5301
Authorized Official
Title or Position : PRESIDENT AND CEO
Name : MR. RICHARD E HUDSON
Credential :
Telephone Number : 252-399-8139
Provider Enumeration Date : 07/27/2009
Last Update Date : 08/11/2009

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Directions to “WILSON MEDICAL CENTER, INC. ” Practice Location

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