Sally Wilson MD PLLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

4301068222 Issued in MI

Legal business name

SALLY WILSON MD PLLC

Practice address

121 S Cochran Ave
Suite C
Charlotte, MI 48813-1568

Phone

(517) 543-9095

Fax

(517) 543-3339

NPI assigned

Feb 29, 2008

Last updated

Feb 29, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Sally K Wilson, MDNPI 1992711964

Title

Owner

Phone

(517) 543-5325

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, and the practitioner matching its NPPES authorized official.

• Sally King Wilson, MD

  • Family Medicine Physician
  • Charlotte, MI
  • NPI 1992711964
  Authorized official Same address or phone

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

{
    "created_epoch": "1204243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204243200000",
    "number": "1275702607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 S COCHRAN AVE",
            "address_2": "SUITE C",
            "city": "CHARLOTTE",
            "state": "MI",
            "postal_code": "488131568",
            "telephone_number": "517-543-9095",
            "fax_number": "517-543-3339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 S COCHRAN AVE",
            "address_2": "SUITE C",
            "city": "CHARLOTTE",
            "state": "MI",
            "postal_code": "488131568",
            "telephone_number": "517-543-9095",
            "fax_number": "517-543-3339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SALLY WILSON MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-29",
        "last_updated": "2008-02-29",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "SALLY",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "517-543-5325",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301068222",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Charlotte, MI
• Providers in Charlotte, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 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.