Provider Demographics
NPI:1558178020
Name:WILSON, JOSEPH RILEY
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:RILEY
Last Name:WILSON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:165 SPRINGDALE DR
Mailing Address - Street 2:
Mailing Address - City:SPINDALE
Mailing Address - State:NC
Mailing Address - Zip Code:28160-2047
Mailing Address - Country:US
Mailing Address - Phone:828-980-2870
Mailing Address - Fax:
Practice Address - Street 1:165 SPRINGDALE DR
Practice Address - Street 2:
Practice Address - City:SPINDALE
Practice Address - State:NC
Practice Address - Zip Code:28160-2047
Practice Address - Country:US
Practice Address - Phone:828-980-2870
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-17
Last Update Date:2024-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program