MEDICARE: DR. GEORGE B WILSON MD

Medicare Provider Information

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0202X	Diagnostic Radiology Physician	17389	WV
2	2085R0202X	Diagnostic Radiology Physician	34700	SC
3	2085R0202X	Diagnostic Radiology Physician	ME112931	FL
4	2085R0202X	Diagnostic Radiology Physician	67934	GA
5	2085R0202X	Diagnostic Radiology Physician	46028	AZ
6	2085R0202X	Diagnostic Radiology Physician	35.122065	OH
7	2085R0202X	Diagnostic Radiology Physician	8184938-1205	UT
8	2085R0202X	Diagnostic Radiology Physician	35929	AL

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
17	300132457	OTHER	WV	RAILROAD MEDICARE

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
9	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
10	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
11	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
12	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
13	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
14	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
15	001718794	OTHER	WV	BCBS
16	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

NPI Number	:	1861491367
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GEORGE B WILSON MD

Provider Business Mailing Address
First Line	:	2006 FRANKLIN STREET
Second Line	:	SUITE 200
City	:	HUNTSVILLE
State	:	AL
Zip	:	35801-4537
Country	:	US
Telephone Number	:	256-539-0457
Fax Number	:	256-539-5827

Provider Business Practice Location Address
First Line	:	2006 FRANKLIN ST SE STE 200
Second Line	:
City	:	HUNTSVILLE
State	:	AL
Zip	:	35801-4537
Country	:	US
Telephone Number	:	256-539-0457
Fax Number	:	256-539-5827

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

Provider Enumeration Date	:	07/18/2005
Last Update Date	:	08/09/2023

2006 FRANKLIN ST SE STE 102
HUNTSVILLE, AL
35801-4537

Practice Phone: 256-251-5121
Practice Fax: 256-469-6061