person
Jerry Dewayne Wilson, PA-C
Medical Physician Assistant in Tucker, Georgia
NPI 1619153210

Jerry Dewayne Wilson is a Medical Physician Assistant based in Decatur, GA and is specialized in Medical. Jerry Dewayne Wilson practices in Tucker, GA and has the professional credentials of PA-C. The NPI Number for Jerry Dewayne Wilson is 1619153210 and holds a License No. 003052 (Georgia).

The current practice location address for Jerry Dewayne Wilson is 4500 Hugh Howell Rd, Tucker, GA and can be reached out via phone at 678-632-4003 and via fax at 678-681-1305.

Location: 4500 Hugh Howell Rd, Tucker, GA, 30036-0550
person
Provider Profile Details
NPI Number
1619153210
Provider Name
Jerry Dewayne Wilson
Credential
PA-C
Provider Entity Type
Individual
Gender
Male
Address
4500 Hugh Howell Rd, Tucker, GA, 30036-0550
Phone Number
678-632-4003
Fax Number
678-681-1305
Provider Enumeration Date
01/14/2008
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
308036587A 05 GA
institution
Provider Business Practice Location Address Details
Address
4500 Hugh Howell Rd
City
State
Zip
30084-4723
Phone Number
678-632-4003
Fax Number
678-681-1305
person
Provider Business Mailing Address Details
Address
4500 Hugh Howell Rd
City
State
Zip
30084-4723
Phone Number
678-632-4003
Fax Number
678-681-1305
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Medical
Taxonomy
License No.
003052 (Georgia)
Definition
Definition to come...
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