RUSSELL ANDREW WILSON (NPI# 1427057736) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427057736 |
| Entity Type | Individual |
| Full Name | RUSSELL ANDREW WILSON |
| Other Name | RUSSELL A WILSON |
| Credential | MD |
| Practice Address |
1265 Highway 54 W Ste 500b Fayetteville GA 30214-4556 |
| Mailing Address |
1265 Highway 54 W Suite 500b Fayetteville GA 30214-4548 |
| Practice Telephone | 7707195660 |
| Practice Fax Number | 6783365955 |
| Mailing Telephone | 7707195660 |
| Mailing Fax Number | 6788174339 |
| Enumeration Date | 2005-07-19 |
| Last Update Date | 2020-07-21 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | 040590 | GA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 00711389C | 05 | |
| GA | RAILROAD MEDICARE | P00081030 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205844230 | Russell Clayton Wilson | Dentist | 2738 W Main St, Visalia, CA 93291-4332 | 2006-08-04 |
| 1780675967 | Russell Carl Wilson | Emergency Medical Technician, Paramedic | 1101 W Eagle Dr, Suite B, Decatur, TX 76234-3721 | 2005-11-04 |
| 1124068432 | Russell Chapman Wilson | Radiology | 3949 Browning Pl, Raleigh, NC 27609-6504 | 2006-06-07 |
| 1487636627 | Russell L. Wilson | Radiology | 1215 Duff Ave, Ames, IA 50010-3014 | 2005-11-15 |
| Street Address |
1265 HIGHWAY 54 W STE 500B |
| City | FAYETTEVILLE |
| State | GA |
| Zip Code | 30214-4556 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568017820 | Fayette Surgical Associates, LLC | Surgery | 1265 Highway 54 W Ste 500b, Fayetteville, GA 30214-4556 | 2019-08-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548872468 | Phyllis Kelly Wood | Nurse Practitioner | 217 Banks Rd, Suite 31, Fayetteville, GA 30214 | 2020-08-21 |
| 1073139317 | Tyisha Salter Scott | Counselor | 110 Habersham Drive, Suite 142, Fayetteville, GA 30214 | 2020-06-23 |
| 1194341412 | Camille Franncine Bolton | Physical Therapist | 500 Floy Farr Parkway, Suite 303, Fayetteville, GA 30214 | 2020-06-23 |
| 1205465895 | Gillian Vaughan Heard | Physician Assistant | 1275 Ga-54 #201, Fayetteville, GA 30214 | 2020-04-06 |
| 1881234557 | Peach Fits,inc | Mastectomy Fitter | 285 Glynn Street South, Suites 102 and 104, Fayetteville, GA 30214 | 2020-01-10 |
| 1255981072 | Delta Healthcare Providers | Clinic/Center | 1275 W Lanier Ave, #200, Fayetteville, GA 30214 | 2019-09-13 |
| 1861965592 | Hierarchy for Wellness | Specialist | 805 S Glynn St Bldg 127 142, Fayetteville, GA 30214 | 2019-01-04 |
| 1356810634 | Fayette Dental Group PC | Clinic/Center | 720 W Lanier Ave, Fayetteville, GA 30214 | 2018-11-16 |
| 1891263299 | Mattie Mae Farmer Clark | Specialist/Technologist, Other | Piedmont Fayette Hospital, 1255 Highway 54 West, Fayetteville, GA 30214 | 2018-11-05 |
| 1093293607 | Allyson Holland | Pharmacist | 880 Highway 85 South, Fayetteville, GA 30214 | 2018-08-06 |
| Find all providers in zip 30214 | ||||
| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164763918 | Cynthia J Amram | Surgery | 3015 E Joyce Blvd, Fayetteville, AR 72703-4526 | 2013-03-04 |
| 1275844177 | Yana Mikhaylov | Surgery | 4140 Ferncreek Dr Ste 601, Fayetteville, NC 28314-2569 | 2010-06-24 |
| 1043541725 | Janine Nicole Pettiford | Surgery | 325 North Jeff Davis Dr, Fayetteville, GA 30214 | 2010-01-20 |
| 1548410103 | Erin M King | Surgery | 1260 Highway 54 W Ste 100, Fayetteville, GA 30214-4513 | 2008-09-19 |
| 1881851699 | Timothee J Friesen | Surgery | 1265 Highway 54 W Ste 309, Fayetteville, GA 30214-4537 | 2008-05-20 |
| 1790954352 | Obinna Chukwudi Igwilo | Surgery | 7300 S Raeford Rd Rm 2528, Fayetteville, NC 28304-6162 | 2008-02-27 |
| 1942387055 | Steven Anthony Battaglia | Surgery | 1061 Brunswick Dr, Fayetteville, OH 45118 | 2006-11-01 |
| 1225118441 | David Crump | Surgery | 108 Medical Center Blvd Ste G25, Fayetteville, TN 37334-2741 | 2006-10-16 |
| 1265544035 | Yong S Kwon | Surgery | 1695 E Rainforest Rd, Fayetteville, AR 72703-5385 | 2006-08-31 |
| 1346261989 | Rudy Theodore Cobb | Surgery | 305 College St W, Fayetteville, TN 37334-2911 | 2006-07-21 |
| Find all providers in FAYETTEVILLE | ||||
| City | FAYETTEVILLE |
| Zip Code | 30214 |
Please comment or provide details below to improve the information on RUSSELL ANDREW WILSON.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.