Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Candace Wilson

Individual provider Emergency Medicine Physician · NPI 1205456217

Candace Wilson is a Family Practice in Pine Bluff, Arkansas. Qualified in 2015, 11 years ago. Practices with Permanente Medical Group Inc, a 10,941-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Arkansas.

Years since qualifying
11
Licensed in
AR
In the registry since
2020
Specialties on file
2

Practice location Address checks out

1601 W 40th Ave Ste 100
Pine Bluff, AR 71603-6069
Phone: (870) 541-6000
Fax: (870) 541-6010
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence E-17243 (AR)
Emergency Medicine Physician Taxonomy 207P00000X · Licence E-17243 (AR)

Record details

NPI number1205456217
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedApril 20, 2020
Last updated in NPPESOctober 18, 2023
Certification dateOctober 18, 2023
Mailing address1601 W 40th Ave Ste 100, Pine Bluff, AR 71603-6069

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolOTHER
Graduated 2015 (11 years in practice)
Group practice Permanente Medical Group Inc — 10941 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

Other providers in Pine Bluff