Jacob Nathaniel Wilson (NPI# 1396192423, PAC ID# 1456605773) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
| Nation Provider ID (NPI) | 1396192423 |
| PAC ID by PECOS | 1456605773 |
| Professional Enrollment ID | I20181126001040 |
| Full Name | Jacob Nathaniel Wilson |
| Address |
333 Whitesport Dr Suite 204 Huntsville AL 35801-3455 |
| Gender | M |
| Medical School | UNIVERSITY OF MISSISSIPPI SCHOOL OF MEDICINE |
| Graduation Year | 2016 |
| Primary Specialty | FAMILY MEDICINE |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 010131 | CRESTWOOD MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 333 Whitesport Dr, Suite 204, Huntsville, AL 35801-3455 |
| Street Address |
333 WHITESPORT DR SUITE 204 |
| City | HUNTSVILLE |
| State | AL |
| Zip | 35801-3455 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Qi Wan | Internal Medicine | 333 Whitesport Dr, Suite 301, Huntsville, AL 35801-3455 | |
| Cheryl Carden Bazzle | Internal Medicine | 333 Whitesport Dr, Suite 103, Huntsville, AL 35801-3455 | |
| Samyuktha C Reddy | Internal Medicine | 333 Whitesport Dr, Suite 304, Huntsville, AL 35801-3455 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| James Gordon Mcmurray | Urology | 303 Williams Sw Ave, Suite 411, Huntsville, AL 35801 | |
| Peter S Wilson | General Surgery | General Surgery Associates | 4704 Whitsburg Dr Se, Suite 200, Huntsville, AL 35801 |
| Diane C Winters | General Surgery | General Surgery Associates | 4704 Whitsburg Dr Se, Suite 200, Huntsville, AL 35801 |
| Philip K. Wiles | General Surgery | General Surgery Associates | 4704 Whitsburg Dr Se, Suite 200, Huntsville, AL 35801 |
| Raymond L Sheppard Jr. | General Surgery | General Surgery Associates | 4704 Whitsburg Dr Se, Suite 200, Huntsville, AL 35801 |
| Clinton Scott Williams | Family Medicine | 420 Lowell Sedr, Suite 107, Huntsville, AL 35801 | |
| John H Lary | Internal Medicine | 600 St Clair Ave Sw, Bldg G Suite 12b, Huntsville, AL 35801 | |
| Bala M Chennupati | Internal Medicine | 250 Chateau Swdr, Suite 220, Huntsville, AL 35801 | |
| Daniel Boyett | General Surgery | General Surgery Associates | 4704 Whitsburg Dr Se, Suite 200, Huntsville, AL 35801 |
| Manmohan K Ghanta | General Surgery | General Surgery Associates | 4704 Whitsburg Dr Se, Suite 200, Huntsville, AL 35801 |
| Find all physicians in zip 35801 | |||
| City | HUNTSVILLE |
| Zip Code | 35801 |
| Specialty | FAMILY MEDICINE |
| City + Specialty | HUNTSVILLE + FAMILY MEDICINE |
Please comment or provide details below to improve the information on Jacob Nathaniel Wilson.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.