DR. KRISTOPHER CHARLES WILSON (NPI# 1649431537) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649431537 |
| Entity Type | Individual |
| Full Name | DR. KRISTOPHER CHARLES WILSON |
| Credential | MD |
| Practice Address |
301 Andrews Avenue Fort Rucker AL 36362-5333 |
| Practice Telephone | 3342557040 |
| Practice Fax Number | 3342557716 |
| Mailing Telephone | 3342557040 |
| Mailing Fax Number | 3342557716 |
| Enumeration Date | 2008-06-23 |
| Last Update Date | 2018-06-07 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 171000000X | Military Health Care Provider | 25420 | NE | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | MILITARY | 2109162460 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 3851 Roger Brooke Drive, Bamc Mcheqd Creds, Fort Sam Houston, TX 782346200 | 7609023909 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578739975 | Kristopher Edward Wilson | Occupational Therapist | 1675 Eagle Harbor Pkwy, Suite B, Orange Park, FL 32003-4802 | 2008-05-06 |
| 1578104824 | Kristopher Dillon Wilson | Physician Assistant | 1324 Lakeland Hills Blvd, Lakeland, FL 33805-4543 | 2019-10-07 |
| 1891210787 | Kristopher Wilson | Physical Therapist | 5535 S Williamson Blvd Ste 774, Port Orange, FL 32128-8321 | 2017-08-11 |
| Street Address |
301 ANDREWS AVENUE |
| City | FORT RUCKER |
| State | AL |
| Zip Code | 36362-5333 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932107307 | James C. Dover | Optometrist | 301 Andrews Avenue, Lyster Army Health Clinic, Fort Rucker, AL 36362-5333 | 2005-07-11 |
| 1598376469 | Wesley Hendrick Mccormick | Psychologist | 301 Andrews Avenue, Fort Rucker, AL 36362 | 2020-08-13 |
| 1366936817 | Twanna Versel Johnson | Social Worker | 301 Andrews Avenue, Cavhcs (va Wiregrass Clinic), Fort Rucker, AL 36362 | 2018-06-19 |
| 1770096406 | Jose A Morejon | Emergency Medical Technician, Basic | 301 Andrews Avenue, Fort Rucker, AL 36362 | 2017-11-16 |
| 1013446723 | Christopher Warren Fleming | Pharmacist | 301 Andrews Avenue, Fort Rucker, AL 36362 | 2017-06-06 |
| 1497296701 | Cody Shedd | Emergency Medical Technician, Basic | 301 Andrews Avenue, Lyster Army Health Clinic, Fort Rucker, AL 36362-5333 | 2017-03-20 |
| 1760924583 | James Darren Beasley | Physical Therapy Assistant | 301 Andrews Avenue, Fort Rucker, AL 36360 | 2016-11-10 |
| 1538616768 | Deseree Moe | Emergency Medical Technician, Basic | 301 Andrews Avenue, Lyster Army Health Clinic, Fort Rucker, AL 36362-5333 | 2016-09-06 |
| 1093261232 | Kristin Henderson | Registered Nurse | 301 Andrews Avenue, Fort Rucker, AL 36362 | 2016-08-28 |
| 1942652490 | Evie Ehret | Occupational Therapist | 301 Andrews Avenue, Fort Rucker, AL 36362 | 2016-07-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235745571 | Rachel Kestler | Specialist | 4102 Gadiator Street, Fort Rucker, AL 36362 | 2020-09-22 |
| 1417589268 | Jacob Michael Lezon | Emergency Medical Technician, Basic | 30501 Nevins St., Ft. Rucker, AL 36362 | 2020-02-10 |
| 1225535388 | Rhonda Lewis Wesolek | Dental Hygienist | Bldg 4405, Innkeeper Street, Fort Rucker, AL 36362 | 2018-04-06 |
| 1770013369 | National Vision, Inc. | Technician/Technologist | Bldg 9214, Fort Rucker, AL 36362 | 2017-06-15 |
| 1750730958 | Teresa Morgan Knighten | Dental Hygienist | 4405 Innkeepers St, Fort Rucker, AL 36362 | 2016-06-08 |
| 1568826246 | David Virgil II | Technician, Other | 2218 6th Avenue Building 4102, Fort Rucker, AL 36362 | 2016-04-08 |
| 1356771257 | Robert E Smith | Emergency Medical Technician, Intermediate | Blding 301 Andrew Ave, Ft Rucker, AL 36362 | 2013-11-14 |
| 1548503469 | Lindsey Taylor Mendenhall | Emergency Medical Technician, Basic | Bldg 301 Andrews Ave 1-223rd Hhc, Lyster Army Health Clinic, Fort Rucker, AL 36362 | 2013-03-28 |
| 1689913808 | Sunland Optical Co., Inc. | Eyewear Supplier (Equipment, not the service) | Fort Rucker Bldg. 9214, Daleville, AL 36362 | 2013-02-07 |
| 1275880205 | Sandra Lynn Griffin Banner | Optometrist | 33 Endl Ave, Fort Rucker, AL 36362 | 2012-08-09 |
| Find all providers in zip 36362 | ||||
| Taxonomy Code | 171000000X |
| Grouping | Other Service Providers |
| Classification | Military Health Care Provider |
| Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes. |
| Notes: [7/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114292885 | Britiney Ann Cawthron | Military Health Care Provider | 301 Andrews Ave, Fort Rucker, AL 36362-0000 | 2012-03-14 |
| 1710171673 | Grace Marie Lidl | Military Health Care Provider | 301 Andrews Ave., Lyster Army Health Clinic, Fort Rucker, AL 36362-5333 | 2007-09-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639785546 | Professional Edge Nursing, Inc | Military Health Care Provider | 600 Mary Lane, Anniston, AL 36207 | 2020-09-17 |
| 1104432152 | Christopher Allen Jones | Military Health Care Provider | 14019 Firehouse Rd, Northport, AL 35475-3408 | 2020-09-16 |
| 1225265788 | Patricia Lynne Walters | Military Health Care Provider | Us Army Aeromedical Research Laboratory, Fort Rucker, Enterprise, AL 36362-0577 | 2009-06-11 |
| 1033360565 | Tejay Wayne Barton | Military Health Care Provider | 101 South Broad St., Mobile, AL 36615 | 2008-10-02 |
| 1306005087 | Sundra Renee Johnson | Military Health Care Provider | 1414 26th St, 1414 26th Street, Tuscaloosa, AL 35401-6642 | 2008-06-06 |
| 1992981922 | Doris Lou Hill | Military Health Care Provider | 1633 Academy Dr, #1405, Auburn, AL 36830-1893 | 2008-01-22 |
| 1497848063 | Douglass Vance | Military Health Care Provider | 264 Belle Dr, Scottsboro, AL 35769-3652 | 2006-10-02 |
| 1144294042 | Michael Bernard Madkins | Military Health Care Provider | 4100 Goss Road, Primary Care Clinic Fox Army Health Center, Redstone Arsenal, AL 35809-7000 | 2006-02-15 |
| 1003955675 | Phillip C Berg | Military Health Care Provider | 8501 Tanner Williams Rd, Mobile, AL 36608-8322 | 2007-02-06 |
| 1184725756 | Felicia Rains Noerager | Military Health Care Provider | 700 19th St S, Birmingham, AL 35233-1927 | 2006-09-26 |
| Find all providers with the same taxonomy | ||||
| City | FORT RUCKER |
| Zip Code | 36362 |
Please comment or provide details below to improve the information on DR. KRISTOPHER CHARLES WILSON.
| 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.