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Contact Information

CARLENE A WILSON, MD
6038 W NORDLING LOOP
CRYSTAL RIVER, FL34429
 Phone: 352-563-5070
 Fax: 352-795-4322
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Internal Medicine

207R00000X 11 Physician/Internal Medicine
 

Pediatrics

208000000X 37 Physician/Pediatric Medicine
Indicates primary specialty

NPI Profile & details for CARLENE A WILSON · (Female)

NPI # 1407850365
Status Active
Credentials MD
Entity Individual
Enumeration date 06/09/2005
Last updated 06/09/2014 - About 12 years ago
Sole proprietor 1 No
Identifiers
  • FL License # ME93743
  • FL Medicaid 273971200
  • GA Medicaid 428955383A
  • SC Medicaid 271841
  • SC Medicaid GP0237
  • FL Other 30031 BLUE CROSS OF FLORIDA
  • SC Other 5705127861001 BLUE CROSS OF SC
Hospital affiliation(s)
  • CITRUS MEMORIAL HOSPITAL - (Acute Care)
    502 W HIGHLAND BLVD
    INVERNESS, FL 34452
  • SEVEN RIVERS REGIONAL MEDICAL CENTER - (Acute Care)
    6201 N SUNCOAST BLVD
    CRYSTAL RIVER, FL 34428
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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