Kenneth L Wilson

Primary specialty

PharmacistTaxonomy code 183500000X

License

10952 Issued in GA

Practice address

4398 Atlanta Hwy
Loganville, GA 30052-7314

Phone

(678) 639-0129

Fax

(678) 639-1547

NPI assigned

Sep 24, 2011

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1316822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316822400000",
    "number": "1972886067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4398 ATLANTA HWY",
            "city": "LOGANVILLE",
            "state": "GA",
            "postal_code": "300527314",
            "telephone_number": "678-639-0129",
            "fax_number": "678-639-1547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4398 ATLANTA HWY",
            "city": "LOGANVILLE",
            "state": "GA",
            "postal_code": "300527314",
            "telephone_number": "678-639-0129",
            "fax_number": "678-639-1547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "KENNETH",
        "middle_name": "L",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-09-24",
        "last_updated": "2011-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "GA",
            "license": "10952",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lorraine Williams, FACHE, DHSC., CHES
• Nakisha Williams, PMHNP
• Stephen B Williams Jr., MA, BCCC
• Janice Wilson
• Joy Stanetrice Wilson, FNP-BC
• Thomas Christopher Wilson, PT
• Jeongi Won
• Marlaina Grant Woodward, BSED
• Blaine Woody, PT
• Magualie Woollery, D.M.D.

• Pharmacist in Loganville, GA
• Providers in Loganville, GA by specialty
• Pharmacist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2011; 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.