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MR. JACK KENNEY WILSON MD NPI 1356349559


NPI Information

NPI: 1356349559
Provider Name: MR. JACK KENNEY WILSON, MD
Classification: Internal Medicine - 207R00000X
Entity Type: Individual
Address:
637 S KERR AVE
WILMINGTON, NC
ZIP 28403
Phone: (910) 799-1810
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MR. Jack Kenney Wilson, MD is an internal medicine in Wilmington, NC. The provider is a physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. MR. Jack Kenney Wilson, MD NPI is 1356349559. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

637 S KERR AVE
WILMINGTON, NC
ZIP 28403-423
Phone: (910) 799-1810
Fax: (910) 452-2571

The enumeration date for this NPI number is 7/12/2005 and was last updated on 9/20/2012.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207R00000XInternal Medicine16755NORTH CAROLINAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
18902701MEDICAIDNORTH CAROLINA
2C80602MEDICARE UPIN
302701OTHERNORTH CAROLINABCBS NC
4230261MEDICARE ID-TYPE UNSPECIFIEDNORTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.