MEDICARE: JON JAY WILSON DO

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
1	208VP0000X	Pain Medicine Physician	200200477	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	132NE	OTHER	NC	BLUE CROSS/BLUE SHIELD

General Provider Information

NPI Number	:	1548298334
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JON JAY WILSON DO

Provider Business Mailing Address
First Line	:	5213 S ALSTON AVE
Second Line	:
City	:	DURHAM
State	:	NC
Zip	:	27713-4430
Country	:	US
Telephone Number	:	919-684-8111
Fax Number	:

Provider Business Practice Location Address
First Line	:	3480 WAKE FOREST RD
Second Line	:	SUITE 208
City	:	RALEIGH
State	:	NC
Zip	:	27609-7376
Country	:	US
Telephone Number	:	919-781-4541
Fax Number	:	919-781-4812

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/29/2006
Last Update Date	:	05/08/2012

Similar Medicare Providers

1386618379 — ANN E WHITAKER PA
Practice Location Address:

3480 WAKE FOREST RD , SUITE 500
RALEIGH, NC
27609-7376

Practice Phone: 919-862-5650
Practice Fax:

1720028558 — PIEDMONT SPINE SPECIALISTS, PA
Practice Location Address:

3480 WAKE FOREST RD , SUITE 208
RALEIGH, NC
27609-7376

Practice Phone: 919-781-4541
Practice Fax: 919-781-4812

1245267269 — JOSHUA SMITH MS, ATC, MHS, PA-C
Practice Location Address:

3480 WAKE FOREST RD STE 208
RALEIGH, NC
27609-7376

Practice Phone: 919-781-4541
Practice Fax:

1740213867 — CHARLES J VIVIANO MD
Practice Location Address:

3480 WAKE FOREST RD , STE 506
RALEIGH, NC
27609-7376

Practice Phone: 919-862-5600
Practice Fax:

1427081611 — PRIVATE DIAGNOSTIC CLINIC, PLLC
Practice Location Address:

3480 WAKE FOREST RD , SUITE 502
RALEIGH, NC
27609-7376

Practice Phone: 919-862-5620
Practice Fax:

1497771992 — PRIVATE DIAGNOSTIC CLINIC, PLLC
Practice Location Address:

3480 WAKE FOREST RD , SUITE 414
RALEIGH, NC
27609-7376

Practice Phone: 919-684-8111
Practice Fax:

Directions to “ JON JAY WILSON DO” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.