Wilson, Gary G

Wilson, Gary G is an individual health care provider with primary practice located at 10415 Wallace Alley St , Kingsport TN 37663-3936. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anesthesiology, which is considered as his primary health care specialty. Wilson, Gary G can be contacted via phone (423) 390-0451.

Contact Information

Primary practice address
10415 Wallace Alley St Kingsport TN 37663-3936
Phone: (423) 390-0451
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X MD0000025656 Tennessee

Profile Details

NPI number 1679573505
LBN Legal business name Wilson, Gary G
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 21st, 2005
Last updated Jun 18th, 2026 - about 4 months ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1679573505 NPPES
Tennessee MEDICAID 3083961

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