| Wilson Family Medicine Llc | |
|
2621 Mitcham Dr Unit 103 Tallahassee FL 32308-5480 | |
| (850) 219-2273 | |
| (850) 201-2410 |
| Full Name | Wilson Family Medicine Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 2621 Mitcham Dr, Tallahassee, Florida |
| Authorized Official Name and Position | Vicari Susan Erwin-wilson (BUSSINESS OWNER/MD) |
| Authorized Official Contact | 8502192273 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wilson Family Medicine Llc 2621 Mitcham Drive Unit 103 Tallahassee FL 32308-5307 Ph: (850) 219-2273 | Wilson Family Medicine Llc 2621 Mitcham Dr Unit 103 Tallahassee FL 32308-5480 Ph: (850) 219-2273 |
| NPI Number | 1588601421 |
|---|---|
| Provider Enumeration Date | 05/31/2006 |
| Last Update Date | 09/30/2008 |
| Medicare PECOS PAC ID | 7911069257 |
|---|---|
| Medicare Enrollment ID | O20081222000297 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588601421 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 800017593 (Florida) | Primary |
| Provider Name | Vicari S Erwin-wilson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356388284 PECOS PAC ID: 8921163502 Enrollment ID: I20120220000949 |
| Provider Name | Leslie D Wilson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720029895 PECOS PAC ID: 7012072697 Enrollment ID: I20120224000646 |
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