Provider Demographics
NPI:1437563293
Name:WILSON, WILLIAM SCOT (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:SCOT
Last Name:WILSON
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 WOODVALE DR
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:AL
Mailing Address - Zip Code:35756-4199
Mailing Address - Country:US
Mailing Address - Phone:205-789-4658
Mailing Address - Fax:
Practice Address - Street 1:285 DUNLOP BLVD SW
Practice Address - Street 2:SUITE A
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35824-1119
Practice Address - Country:US
Practice Address - Phone:256-713-3975
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-19
Last Update Date:2014-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL17673183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist