Provider Demographics
NPI:1306609599
Name:WILSON OBSTETRICS, GYNECOLOGY & INFERTILITY, INC
Entity type:Organization
Organization Name:WILSON OBSTETRICS, GYNECOLOGY & INFERTILITY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ERICA
Authorized Official - Middle Name:
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-300-2410
Mailing Address - Street 1:PO BOX 12860
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-4019
Mailing Address - Country:US
Mailing Address - Phone:919-334-0123
Mailing Address - Fax:
Practice Address - Street 1:2500 HORTON BLVD SW
Practice Address - Street 2:
Practice Address - City:WILSON
Practice Address - State:NC
Practice Address - Zip Code:27893-4444
Practice Address - Country:US
Practice Address - Phone:252-206-1000
Practice Address - Fax:252-237-0704
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UWH OF THE CAROLINAS, PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-02-01
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty