MEDICARE: DR. EUGENE WILEY WILSON IV DO

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	2085R0202X	Diagnostic Radiology Physician	02002999A	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1922099746
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. EUGENE WILEY WILSON IV DO

Provider Business Mailing Address
First Line	:	84 MALLET HILL CT
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29223-3126
Country	:	US
Telephone Number	:	803-509-0456
Fax Number	:

Provider Business Practice Location Address
First Line	:	84 MALLET HILL CT
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29223-3126
Country	:	US
Telephone Number	:	803-509-0456
Fax Number	:

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

Provider Enumeration Date	:	11/01/2005
Last Update Date	:	03/20/2013

Similar Medicare Providers

1558508895 — GERIATRIC & FAMILY COUNSELING OF COLUMBIA, LLC
Practice Location Address:

14 MALLET HILL CT
COLUMBIA, SC
29223-3126

Practice Phone: 803-740-5717
Practice Fax:

1528151255 — CAROLYN ANN KNIGHT-SCHLONDROP NP
Practice Location Address:

6326 SAINT ANDREWS RD , SUITE 201
COLUMBIA, SC
29212-3126

Practice Phone: 803-979-9666
Practice Fax: 800-878-6608

1992874614 — CARING HANDS
Practice Location Address:

6300 SAINT ANDREWS RD STE D
COLUMBIA, SC
29212-3126

Practice Phone: 803-750-9887
Practice Fax: 803-750-9994

1366578502 — KARL STEPHEN KLINAR D.M.D.
Practice Location Address:

6320 SAINT ANDREWS RD
COLUMBIA, SC
29212-3126

Practice Phone: 803-772-5161
Practice Fax: 803-772-4441

1629389473 — KNIGHT-SCHLONDROP, LLC
Practice Location Address:

6326 SAINT ANDREWS RD , SUITE # 201
COLUMBIA, SC
29212-3126

Practice Phone: 803-979-9666
Practice Fax: 800-878-6608

1679958532 — MAKEEBA BOOKHART POUGH D.M.D
Practice Location Address:

3126 DEVINE ST
COLUMBIA, SC
29205-1846

Practice Phone: 803-252-8101
Practice Fax:

Directions to “ DR. EUGENE WILEY WILSON IV DO” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.