| Doctor Name: | CANDICE LYNN WILSON |
| NPI Number: | 1215997028 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.D. |
| License Number: | ME94386 |
| Business Practice Address: | 990 Oak Ridge Tpke Oak Ridge, TN - 378306976 |
| Business Phone Number: | 8658354600 |
| Business Fax Number: | 8658354609 |
| Mailing Address: | Po Box 11105, KNOXVILLE |
| State: | TN |
| Postal Code: | 379391105 |
| Phone Number: | 8655882928 |
| Fax Number: | 8654509374 |
| NPI Enumeration Date: | 03/24/2006 |
| NPI Last Update Date: | 07/24/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 174400000X |
| License Number: | ME94386 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | FL |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Specialist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |