CHARLES V. WILSON MD NPI 1699702910

NPI Information

NPI: 1699702910
Provider Name: CHARLES V. WILSON, MD
Classification: Specialist - 174400000X
Entity Type: Individual
Address:
3525A US HIGHWAY 17
FLEMING ISLAND, FL
ZIP 32003
Phone: (904) 215-3880
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Charles V. Wilson, MD is a specialist in Fleming Island, FL. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. Charles V. Wilson, MD NPI is 1699702910. 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:

3525A US HIGHWAY 17
FLEMING ISLAND, FL
ZIP 32003-122
Phone: (904) 215-3880
Fax: (904) 215-3883

The enumeration date for this NPI number is 6/26/2006 and was last updated on 11/9/2009.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	174400000X	Specialist		AW 1670757	FLORIDA	Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	D62429	MEDICARE UPIN	FLORIDA
2	42181	MEDICARE ID-TYPE UNSPECIFIED	FLORIDA
3	03-0514915	OTHER	FLORIDA	EIN
4	065705100	MEDICAID	FLORIDA

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: 11/14/2023

NPI Synchronization or Removal

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