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

Jefferson Wilson

Individual provider Specialist · NPI 1821464645

Jefferson Wilson is a Specialist in Philadelphia, Pennsylvania. Licensed in Pennsylvania. Registered with an NPI since 2015.

Licensed in
PA
In the registry since
2015

Practice location Address checks out

909 Walnut St Ste 320L
Philadelphia, PA 19107-5211
Phone: (215) 601-8976
Show map & directions

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

Specialties & licences

Specialist (primary) Taxonomy 174400000X · Licence MD454836 (PA)

Record details

NPI number1821464645
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedAugust 16, 2015
Last updated in NPPESAugust 16, 2015

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