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NPI Code Detail

MEDICARE: MICHAEL D WILONS M.D.

MEDICARE: MICHAEL D WILONS M.D.
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
1207RC0200XCritical Care Medicine (Internal Medicine) PhysicianMD7996TN
2207RP1001XPulmonary Disease PhysicianMD7996TN

General Provider Information

NPI Number : 1710983259
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL D WILONS M.D.
Provider Business Mailing Address
First Line : 965 RIDGE LAKE BLVD STE 315
Second Line :
City : MEMPHIS
State : TN
Zip : 38120-9401
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2120 EXETER RD STE 250
Second Line :
City : GERMANTOWN
State : TN
Zip : 38138-3931
Country : US
Telephone Number : 901-767-5864
Fax Number : 901-767-6591
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/21/2005
Last Update Date : 09/22/2022

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