| Doctor Name: | DR. DAWN WILSON |
| NPI Number: | 1053486456 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.D. |
| License Number: | 047279 |
| Business Practice Address: | 5499 Jonesboro Rd Lake City, GA - 302603553 |
| Business Phone Number: | 7708568736 |
| Business Fax Number: | 4043634348 |
| Mailing Address: | 5499 Jonesboro Rd, LAKE CITY |
| State: | GA |
| Postal Code: | 302603553 |
| Phone Number: | 7708568736 |
| Fax Number: | 4043634348 |
| NPI Enumeration Date: | 11/21/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207QA0505X |
| License Number: | 047279 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Family Medicine |
| Taxonomy Specialization: | Adult Medicine |
| Taxonomy Definition: | |