Carmen J Wilson Md Pc

NPI 1053513911 - Ophthalmology - 207W00000X

NPI Details
NPI 1053513911
Enumeration Date 06/04/2007
Last Updated 02/26/2010
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name CARMEN J CARMEN
Position OWNER
Phone (678) 914-4733
Fax (404) 286-2020
Practice Location
1760 CANDLER RD
SUITE D
DECATUR GA, 30032-3254, US
Phone (678) 914-4733
Fax (404) 286-2020
Business Location
67 HARBOUR LAKE DRIVE
FAYETTEVILLE GA, 30215, US
Phone (678) 914-4733
Fax (770) 474-4620
Toxanomy
Taxonomy Code 207W00000X
License State Georgia
License Number 044609
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According to our database, Carmen J Wilson Md Pc NPI is 1053513911, taxonomy code is 207W00000X and license number is 044609, license state is located at Georgia. Carmen J Wilson Md Pc physically located at 1760 Candler Rd, Decatur GA, 30032-3254. NPI Number 1033115704 has the healthcare provider type.

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1053513911 NPI number is provided on an as is basis without warranty of any kind. 1053513911 is maintained by the National Plan & Provider Enumeration System. The contents of Carmen J Wilson Md Pc are for informational purposes only.