Provider Demographics
NPI:1467483750
Name:WILSON, JAMES (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:
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:PO BOX 366
Mailing Address - Street 2:
Mailing Address - City:OCEAN CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:08226-0366
Mailing Address - Country:US
Mailing Address - Phone:609-399-0700
Mailing Address - Fax:
Practice Address - Street 1:213 WEST AVE
Practice Address - Street 2:
Practice Address - City:OCEAN CITY
Practice Address - State:NJ
Practice Address - Zip Code:08226
Practice Address - Country:US
Practice Address - Phone:609-399-0700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA040447207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0105776000OtherAMERIHEALTH HMO, POS
NJ160019035OtherMEDICARE RAILROAD
NJ2173000Medicaid
NJ456642OtherAMERIHEALTH PP0
NJ1K1289OtherHEALTHNET
NJ577082OtherOXFORD
NJPRUDENTIALOther2225512321-00
NJ456642Medicare ID - Type Unspecified
NJ1K1289OtherHEALTHNET