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NPI Profile for JOE WILSON in MACON, GA.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Professional |
101YP2500X |
| NPI Number | 1023304599 |
|
| Status | Active | |
| Credentials | L.P.C. | |
| Entity | Individual | |
| Enumeration date | 06/23/2011 | |
| Last updated | 02/24/2015 - About 11 years ago | |
| Sole proprietor 1 | Yes | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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JOE WILSON
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JOE WILSON, L.P.C.