Wilson Internal Medicine PA

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

12953 Issued in SC

Legal business name

WILSON INTERNAL MEDICINE PA

Practice address

4840 Forest Dr
Box 255
Columbia, SC 29206-4810

Phone

(803) 799-0201

Fax

(803) 799-0304

NPI assigned

Mar 21, 2006

Organization subpart

No

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

Authorized official

Name

Dr. William D. Wilson Jr., M. D.NPI 1891741591

Title

Physician

Phone

(803) 799-0201

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• William Drayton Wilson Jr., MD

  • Internal Medicine Physician
  • Columbia, SC
  • NPI 1891741591
  NPD (past) Authorized official

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

{
    "created_epoch": "1142899200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1220918400000",
    "number": "1215996046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4840 FOREST DR",
            "address_2": "BOX 255",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292064810",
            "telephone_number": "803-799-0201",
            "fax_number": "803-799-0304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4840 FOREST DR",
            "address_2": "BOX 255",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292064810",
            "telephone_number": "803-799-0201",
            "fax_number": "803-799-0304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILSON INTERNAL MEDICINE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-21",
        "last_updated": "2008-09-09",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "803-799-0201",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M. D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "SC",
            "license": "12953",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carmen Willm, OT
• Jonathan Gabriel Wills
• Jordyn Wills
• Kristy Jo Willson
• Breanna Wilsom
• Natosha Wilson-Glenn, RN
• Marjorie Denise Wilson-Turner, LCPC
• A'Kaila Monae Wilson, M.A.,CCC-SLP
• Alex Mary Logan Wilson, DO
• Aliyah Inez Wilson

• Primary Care Clinic/Center in Columbia, SC
• Providers in Columbia, SC by specialty
• Primary Care Clinic/Center in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2008; 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.