Provider Demographics
NPI:1992869903
Name:WILSON, MARCUS GARVEY (MD)
Entity type:Individual
Prefix:
First Name:MARCUS
Middle Name:GARVEY
Last Name:WILSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 TOWNCENTER BLVD
Mailing Address - Street 2:SUITE 112
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35406-1833
Mailing Address - Country:US
Mailing Address - Phone:205-750-0030
Mailing Address - Fax:205-750-0855
Practice Address - Street 1:100 TOWNCENTER BLVD
Practice Address - Street 2:SUITE 112
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35406-1833
Practice Address - Country:US
Practice Address - Phone:205-750-0030
Practice Address - Fax:205-750-0855
Is Sole Proprietor?:No
Enumeration Date:2006-12-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL00025778207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology