Individual provider · NPI-1

Dr. William Robert Wilson Jr., MD

Family Medicine · Fort Rucker, AL

NPI number1013282755
StatusActive
Last updated in NPPESAug 25, 2022

Details

NPI
1013282755
Entity type
Individual (NPI-1)
Name
Dr. William Robert Wilson Jr.
Credential
MD
Sex
Male
Sole proprietor
Yes
Enumeration date
Mar 13, 2012
Certification date
Aug 23, 2022
Last updated
Aug 25, 2022

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family Medicine67837GAYes
390200000X Student in an Organized Health Care Education/Training Program––

Practice location

Building 301
301 Andrews Avenue
Fort Rucker, AL 36362-5333

Phone 800-261-7193

Mailing address

Building 301
301 Andrews Avenue
Fort Rucker, AL 36362-5333

Phone 800-261-7193

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