DR. JEFFREY JOHN WILSON M.D. NPI 1811015092

NPI Information

DR. Jeffrey John Wilson, M.D. is a child and adolescent psychiatry psychiatry neurology in Roanoke, VA. The provider is child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. DR. Jeffrey John Wilson, M.D. NPI is 1811015092. 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:

2017 JEFFERSON ST SW
ROANOKE, VA
ZIP 24014-419
Phone: (540) 853-0900
Fax: (540) 853-0518

The NPI 1811015092 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), Power Mobility Devices.

The enumeration date for this NPI number is 3/27/2007 and was last updated on 12/24/2014.

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:

Other Identifiers

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

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