Provider Demographics
NPI:1043287618
Name:WILSON, CHRISTOPHER JEROME (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:JEROME
Last Name:WILSON
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1201 ALHAMBRA BLVD
Mailing Address - Street 2:SUITE 410
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95816-5243
Mailing Address - Country:US
Mailing Address - Phone:916-457-4263
Mailing Address - Fax:916-731-7809
Practice Address - Street 1:1201 ALHAMBRA BLVD
Practice Address - Street 2:SUITE 410
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95816-5243
Practice Address - Country:US
Practice Address - Phone:916-457-4263
Practice Address - Fax:916-731-7809
Is Sole Proprietor?:No
Enumeration Date:2006-03-02
Last Update Date:2010-08-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CO36565207XS0106X
CAA106196207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1047304594Medicare NSC