DR. ADDISON GRAVES WILSON JR. (NPI# 1770660060) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770660060 |
| Entity Type | Individual |
| Full Name | DR. ADDISON GRAVES WILSON JR. |
| Credential | MD |
| Practice Address |
1840 Cove Rd Logsu-2 Medical Department Norfolk VA 23521-2910 |
| Mailing Address |
1 Pinckney Blvd Beaufort SC 29902-6122 |
| Practice Telephone | 7574623025 |
| Mailing Telephone | 8432285455 |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2019-05-06 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207QA0505X |
Family Medicine Specialization: Adult Medicine |
A97126 | CA | Allopathic & Osteopathic Physicians |
| Y | 207X00000X | Orthopaedic Surgery | MD40144 | SC | Allopathic & Osteopathic Physicians |
| N | 208D00000X | General Practice | 0101242561 | VA | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861424764 | Addison R Wilson | Family Medicine | 15285 Nw Central Dr, Portland, OR 97229-0973 | 2006-07-07 |
| Street Address |
1840 COVE RD LOGSU-2 MEDICAL DEPARTMENT |
| City | NORFOLK |
| State | VA |
| Zip Code | 23521-2910 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720352958 | Omar Antonio Pescador | Military Health Care Provider | Seal Team 10 Medical Department, Bldg 3808, Virginia Beach, VA 23521 | 2012-03-06 |
| 1013219591 | Naval Special Warfare Group Three Det Little Creek | Military Hospital | 1840 Intercove Rd, Norfolk, VA 23521 | 2010-12-03 |
| 1750610788 | Melissa Christine Foster | Military Health Care Provider | 2901 Amphibious Drive, Acu-2, Norfolk, VA 23521 | 2009-12-22 |
| 1396837068 | Sharon A Raghubar | Dentist | Nab Little Creek, 1035 Nider Blvd. Suite 200, Norfolk, VA 23521 | 2006-09-29 |
| 1073581823 | Karen Hintz Charlton | Physician Assistant | 1035 Nidar Blvd, Norfolk, VA 23521 | 2006-03-09 |
| 1518937846 | Timothy Paul Tobin | Optometrist | Branch Medical Clinic, Little Creek, 1035 Nider Blvd Ste 100, Norfolk, VA 23521 | 2006-01-26 |
| 1225273691 | Jason Paul Arceneaux | Military Health Care Provider | 1355 Helicopter Rd, Norfolk, VA 23521 | 2008-12-12 |
| 1679749220 | Christopher J Marquez | Military Health Care Provider | 1840 Gator Blvd, Seal Team Two Bldg 3841, Norfolk, VA 23521 | 2008-05-05 |
| 1073513099 | Thomas Schlater | Optometrist | 1035 Nider Blvd, Norfolk, VA 23521 | 2005-08-01 |
| 1902066731 | Scott Lafountaine | Military Health Care Provider | 1840 Cove Road, Naval Special Warfare Group Two Medical Department, Norfolk, VA 23521-2100 | 2008-06-16 |
| Find all providers in zip 23521 | ||||
| Taxonomy Code | 207X00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891953485 | Tom A Hong | Orthopaedic Surgery | 844 Kempsville Rd Ste 104, Norfolk, VA 23502-3927 | 2008-05-30 |
| 1437248622 | Charles E. Shuff | Orthopaedic Surgery | 6160 Kempsville Cir Ste 200b, Norfolk, VA 23502 | 2006-10-12 |
| 1346218195 | Cara D Novick | Orthopaedic Surgery | 171 Kempsville Rd, Building A, Norfolk, VA 23502-4700 | 2006-03-09 |
| 1831195353 | Anthony J Distasio II | Orthopaedic Surgery | 600 Gresham Dr Ste 204, Norfolk, VA 23507-1904 | 2005-06-21 |
| 1073005625 | Stephen H. Mccoy | Orthopaedic Surgery | 830 Southampton Ave, Norfolk, VA 23510-1001 | 2018-05-30 |
| 1598136855 | Orthopaedic Specialists of Massachusetts, LLC | Orthopaedic Surgery | 31 Pine St, Norfolk, MA 02056-1642 | 2015-10-13 |
| 1003284357 | Uosife Alfahd | Orthopaedic Surgery | 930 W 21st St, Suite 100, Norfolk, VA 23517 | 2015-09-03 |
| 1013310572 | Bon Secours Depaul Medical Center Inc. | Orthopaedic Surgery | 930 W 21st St Ste 100, Norfolk, VA 23517-1516 | 2014-09-29 |
| 1912337486 | Jennifer Marie Byrd | Orthopaedic Surgery | 6160 Kempsville Cir Ste 200b, Norfolk, VA 23502-3945 | 2013-11-20 |
| 1487977161 | Vann Virginia Center for Orthopaedics | Orthopaedic Surgery | 6275 E Virginia Beach Blvd, Suite 300, Norfolk, VA 23502-2851 | 2010-03-09 |
| Find all providers in NORFOLK | ||||
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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.