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NPI Code Detail

MEDICARE: MR. JULIUS ELIZAH WILSON-SMALL

MEDICARE:  MR. JULIUS ELIZAH WILSON-SMALL
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
1101YP1600XPastoral CounselorOH

General Provider Information

NPI Number : 1699639146
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JULIUS ELIZAH WILSON-SMALL
Provider Business Mailing Address
First Line : 686 WEDGEWOOD DR APT 8
Second Line :
City : COLUMBUS
State : OH
Zip : 43228-4315
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 686 WEDGEWOOD DR APT 8
Second Line :
City : COLUMBUS
State : OH
Zip : 43228-4315
Country : US
Telephone Number : 614-736-9214
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/10/2025
Last Update Date : 12/10/2025

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Directions to “ MR. JULIUS ELIZAH WILSON-SMALL ” Practice Location

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