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

Mr. Samuel D Wilson III

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1699692988

Mr. Samuel D Wilson III is a Student in an Organized Health Care Education/Training Program in Jefferson, Georgia. Practices as a sole proprietor. Registered with an NPI since 2026.

In the registry since
2026

Practice location Address checks out

86 Eagle View Dr
Jefferson, GA 30549-7023
Phone: (719) 425-1077
Show map & directions

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

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X

Record details

NPI number1699692988
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedJune 30, 2026
Last updated in NPPESJune 30, 2026
Certification dateJune 30, 2026

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