MR. CHARLES OMAR WILSON JR. (NPI# 1497066518) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497066518 |
| Entity Type | Individual |
| Full Name | MR. CHARLES OMAR WILSON JR. |
| Credential | M.D. |
| Practice Address |
175 Samaritan Way Jasper GA 30143 |
| Mailing Address |
747 Redfield Way Jasper GA 30143 |
| Practice Telephone | 7062534673 |
| Practice Fax Number | 7062534675 |
| Mailing Telephone | 7066920812 |
| Mailing Fax Number | 7066920812 |
| Enumeration Date | 2010-06-23 |
| Last Update Date | 2010-06-28 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207ZP0102X |
Pathology Specialization: Anatomic Pathology & Clinical Pathology |
050283 | GA | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538715305 | Charles Louis Wilson | Massage Therapist | 2900 Government St Ste A, Ocean Springs, MS 39564-5647 | 2019-08-16 |
| 1447770086 | Charles Lynn Wilson Jr. | Case Manager/Care Coordinator | 200 S Chambers Ave Lot 26, Claremore, OK 74017-5203 | 2017-06-25 |
| 1750744678 | Charles Jay Wilson | Counselor | 711 N Market Ave, Bolivar, MO 65613-1114 | 2016-03-29 |
| 1063838639 | Charles Lloyd Wilson | Hospitalist | Mercy South, 5200 E I-240 Service Road, Oklahoma City, OK 73135 | 2014-03-06 |
| 1114295896 | Charles Everett Wilson | Dermatology | 2211 Fernwood Ct, Grand Junction, CO 81506-6062 | 2011-12-08 |
| 1518249424 | Charles Christian Wilson IIi | Pharmacist | 3240 Ivory Coast Dr, Las Vegas, NV 89117-2269 | 2011-09-16 |
| 1629399522 | Charles Brent Wilson | Dentist | 7689 Us Hwy 61, Saint Francisville, LA 70775-0820 | 2010-06-15 |
| 1376705434 | Charles Emmons Wilson | Marriage & Family Therapist | 511north 12th St, Riverton, WY 82501 | 2008-06-30 |
| 1598953184 | Charles Wilson | Physical Therapist | 43 Bowman Dr, Waynesville, NC 28785-6115 | 2007-10-09 |
| 1295933471 | Charles Richard Wilson | Surgery | 6 Woodland Rd Ste 205, Saint Helena, CA 94574-9501 | 2007-07-10 |
| Street Address |
175 SAMARITAN WAY |
| City | JASPER |
| State | GA |
| Zip Code | 30143 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073111845 | George Mackel, Pmhnp-bc, LLC | Nurse Practitioner | 12034 Big Canoe, 400 Shetland Trace, Jasper, GA 30143 | 2020-10-14 |
| 1598363434 | Amanda J Griggs | Massage Therapist | 54 Wolfscratch Village, Jasper, GA 30143 | 2020-10-13 |
| 1801397724 | Jema Day | Nurse Practitioner | 620 J L White Dr Ste 140, Jasper, GA 30143 | 2018-02-26 |
| 1023467545 | North Georgia Personal Care LLC | Home Health | 501 North Main St., Suite B, Jasper, GA 30143 | 2016-06-06 |
| 1871979641 | Sj & J Spine and Pain Group Holding LLC | Pain Medicine | 91 Sammy Mcghee Blvd, Suite 101, Jasper, GA 30143 | 2015-08-04 |
| 1801294293 | Highland Recovery Center | Community/Behavioral Health | 323 Roland Road, Jasper, GA 30143 | 2014-12-17 |
| 1770905861 | Leslie Rhea Hanagan | Speech-Language Pathologist | 22 Dogwood Lane, Jaser, GA 30143 | 2014-01-09 |
| 1669800660 | Pickens County Chiropractic | Chiropractor | 95 North Main Street, Jasper, GA 30143 | 2013-10-29 |
| 1407139264 | Rocky Mountain Holdings LLC | Ambulance | 70 Airport Business Court, Jasper, GA 30143 | 2011-09-27 |
| 1851681415 | Richard J Vandam | Internal Medicine | 1266 Highway 515, Piedmont Mountainside Hospital, Jasper, GA 30143 | 2011-04-15 |
| Find all providers in zip 30143 | ||||
| Taxonomy Code | 207ZP0102X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pathology |
| Specialization | Anatomic Pathology & Clinical Pathology |
| A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added, 7/1/2009: definition reformatted] Additional Resources: American Board of Pathology, 2007. http://www.abpath.org/ This taxonomy code identifies the combined anatomic pathology & clinical pathology route. Board certification for Medical Doctors (MDs) is provided by the American Board of Pathology. To acknowledge the diverse activities in the practice of pathology and to accommodate the interests of individuals wanting to enter the field, the ABP offers primary certification through the following three routes: combined anatomic pathology and clinical pathology, anatomic pathology only and clinical pathology only. Primary certification in anatomic pathology or clinical pathology may be combined with some of the subspecialty certifications. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508920125 | David F. Harris | Pathology | 608 9th Ave, Jasper, AL 35501-4248 | 2006-12-20 |
| 1093702375 | Hoosier Pathology PC | Pathology | 800 W 9th St, Jasper, IN 47546-2514 | 2005-10-03 |
| 1417944976 | Daniel C Weaver | Pathology | 800 W 9th St, Jasper, IN 47546-2514 | 2005-09-30 |
| 1043205941 | Maximilian J Kremzar | Pathology | 800 W 9th St, Jasper, IN 47546-2514 | 2005-09-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255957148 | Thomas E Cotter | Pathology | 1120 15th St # Bf-103b, Augusta, GA 30912-0004 | 2020-06-17 |
| 1386269835 | Pramila Pallikkappara Moideen | Pathology | Augusta University Medical Center Room Bf-103-b, Augusta, GA 30912-0001 | 2020-06-10 |
| 1558921973 | Anna Nielsen Walker | Pathology | Mercer University School of Medicine Dept of Pathology, Macon, GA 31207-0001 | 2019-06-18 |
| 1437678950 | Thomas William Stewart Jr. | Pathology | 3138 Marthasville Court, Gainesville, GA 30506 | 2017-09-15 |
| 1700225760 | Robert John Nelms Jr. | Pathology | 107 Fairway Dr, Moultrie, GA 31768-6823 | 2013-06-22 |
| 1750725099 | Charles Jacob Stoudenmire | Pathology | 507 W 3rd Ave Ste 7, Albany, GA 31701 | 2013-04-17 |
| 1902143589 | Lindsey Oreita Lowder | Pathology | 1968 Peachtree Rd Nw Bldg 774th, Atlanta, GA 30309-1281 | 2013-01-15 |
| 1184918476 | Stephen Alan Dayan | Pathology | 830 Johns Landing Way, Lawrenceville, GA 30045-6369 | 2011-06-03 |
| 1760793673 | Andrew Erling Johnsen | Pathology | 3248 Avalon Pkwy, Conyers, GA 30013-6320 | 2010-06-24 |
| 1073840864 | Jyotsna K Dhar | Pathology | 1331 Marietta Country Club Dr Nw, Kennesaw, GA 30152-4733 | 2009-11-16 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.