MEDICARE: DR. JERRY SCOTT WILSON 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
1	2084P0800X	Psychiatry Physician	35.085695	OH
2	2084P0800X	Psychiatry Physician	0101242897	VA
3	2084P0800X	Psychiatry Physician	45754	TN

General Provider Information

NPI Number	:	1740385483
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JERRY SCOTT WILSON M.D.

Provider Business Mailing Address
First Line	:	2014 QUAIL HOLLOW CIR
Second Line	:
City	:	FRANKLIN
State	:	TN
Zip	:	37067-5967
Country	:	US
Telephone Number	:	615-322-3000
Fax Number	:

Provider Business Practice Location Address
First Line	:	2010 QUAIL HOLLOW CIR
Second Line	:
City	:	FRANKLIN
State	:	TN
Zip	:	37067-5967
Country	:	US
Telephone Number	:	615-322-3000
Fax Number	:

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

Provider Enumeration Date	:	09/14/2006
Last Update Date	:	09/18/2025

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