Wilson, Jerry Paul

Wilson, Jerry Paul is an individual health care provider with primary practice located at 6041 Telecom Dr , Milan TN 38358-3448. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Wilson, Jerry Paul can be contacted via phone (731) 686-1505.

Contact Information

Primary practice address
6041 Telecom Dr Milan TN 38358-3448
Phone: (731) 686-1505
Fax: (731) 686-8174
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X MD24812 Tennessee

Profile Details

NPI number 1144206962
LBN Legal business name Wilson, Jerry Paul
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 22nd, 2005
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1144206962 NPPES
Tennessee MEDICAID 3078043

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