Provider Demographics
NPI:1619119054
Name:WILSON, HELEN HEEYOUNG (MD)
Entity Type:Individual
Prefix:
First Name:HELEN
Middle Name:HEEYOUNG
Last Name:WILSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:HELEN
Other - Middle Name:HEEYOUNG
Other - Last Name:LEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1009 NOVUS DR STE 2
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37604-8237
Mailing Address - Country:US
Mailing Address - Phone:423-283-0776
Mailing Address - Fax:423-968-5697
Practice Address - Street 1:1009 NOVUS DR STE 2
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37604-8237
Practice Address - Country:US
Practice Address - Phone:423-283-0776
Practice Address - Fax:423-968-5697
Is Sole Proprietor?:No
Enumeration Date:2009-03-31
Last Update Date:2021-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD58161207L00000X
CAA113483207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology