DR. Jack T Wilson Iii, D.M.D. is a general practice dentist in Louisville, KY. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. DR. Jack T Wilson Iii, D.M.D. NPI is 1396880902. 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:
12010 SHELBYVILLE RD
SUITE 200
LOUISVILLE, KY
ZIP 40243-054
Phone: (502) 583-4771
Fax: (502) 584-9922
The NPI 1396880902 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).
The enumeration date for this NPI number is 2/21/2007 and was last updated on 7/8/2007.