Provider Demographics
NPI:1003958885
Name:WILSON, GEORGE F (MD)
Entity type:Individual
Prefix:
First Name:GEORGE
Middle Name:F
Last Name:WILSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:450 SAINT EMANUEL ST
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36603-2240
Mailing Address - Country:US
Mailing Address - Phone:251-455-4141
Mailing Address - Fax:
Practice Address - Street 1:450 SAINT EMANUEL ST
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36603-2240
Practice Address - Country:US
Practice Address - Phone:251-455-4141
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-12
Last Update Date:2025-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL27165207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009943133Medicaid
MS04557853Medicaid
AL51541318OtherBCBS - KNOLLWOOD DR
AL51541318OtherBCBS - KNOLLWOOD DR