Provider Demographics
NPI:1073737995
Name:WILSON RADIATION ONCOLOGY ASSOCIATES, PA
Entity Type:Organization
Organization Name:WILSON RADIATION ONCOLOGY ASSOCIATES, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:C
Authorized Official - Last Name:METTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-399-7400
Mailing Address - Street 1:PO BOX 63224
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28263-3224
Mailing Address - Country:US
Mailing Address - Phone:770-693-2622
Mailing Address - Fax:
Practice Address - Street 1:1703 MEDICAL PARK DR W
Practice Address - Street 2:
Practice Address - City:WILSON
Practice Address - State:NC
Practice Address - Zip Code:27893-2788
Practice Address - Country:US
Practice Address - Phone:252-399-7400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-12
Last Update Date:2017-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89138K5Medicaid
NC2347253Medicare PIN