James P Wilson MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

ME0039417 Issued in FL

Legal business name

JAMES P WILSON MD

Practice address

203 Cloverdale Blvd
Fort Walton Beach, FL 32547-1405

Phone

(850) 862-7604

Fax

(850) 862-8156

NPI assigned

Aug 5, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Heather Wilson

Title

Practice Manager

Phone

(850) 862-7604

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1358899200000",
    "number": "1023027315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 CLOVERDALE BLVD",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325471405",
            "telephone_number": "850-862-7604",
            "fax_number": "850-862-8156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 CLOVERDALE BLVD",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325471405",
            "telephone_number": "850-862-7604",
            "fax_number": "850-862-8156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAMES P WILSON MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-05",
        "last_updated": "2013-01-23",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "850-862-7604"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME0039417",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Fort Walton Beach, FL
• Providers in Fort Walton Beach, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.