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NPI Code Detail

MEDICARE: WILSON ALLEY MD

MEDICARE: WILSON ALLEY MD
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
1208600000XSurgery Physician45419AL

General Provider Information

NPI Number : 1811487101
Entity Type Code : Individual
Provider Name (Legal Business Name) : WILSON ALLEY MD
Provider Business Mailing Address
First Line : 380 WOODS COVE ROAD
Second Line :
City : SCOTTSBORO
State : AL
Zip : 35768-6656
Country : US
Telephone Number : 256-259-0185
Fax Number : 256-259-0317
Provider Business Practice Location Address
First Line : 300 2ND AVE
Second Line :
City : LONG BRANCH
State : NJ
Zip : 07740-6395
Country : US
Telephone Number : 205-718-1983
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/13/2018
Last Update Date : 10/19/2023

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Directions to “ WILSON ALLEY MD” Practice Location

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