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MR. JACK KENNEY WILSON JR. MD
NPI 1356349559
Internal Medicine in Wilmington, NC

Active since July 12, 2005
637 S KERR AVE, WILMINGTON, NC 28403(910) 799-1810(910) 452-2571 Get Directions Write a Review

NPPES record last updated: September 20, 2012. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Mr. Jack Kenney Wilson Jr. Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. JACK KENNEY WILSON JR. MD (NPI 1356349559) is an individual internal medicine provider in Wilmington, North Carolina, licensed in North Carolina (16755) and active in the NPI registry since July 2005.

NPPES Registry Identity

NPI1356349559
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameMR. JACK KENNEY WILSON JR.Credential: MD
Location Address637 S KERR AVEWilmington, NC 28403-8423
Mailing Address637 S Kerr AveWilmington, NC 28403-8423 · (910) 799-1810 · Fax (910) 452-2571
Phone(910) 799-1810
Fax(910) 452-2571
Sole ProprietorNo
Enumeration DateJuly 12, 2005
Last NPPES UpdateSeptember 20, 2012
✔ NPI 1356349559 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in NC · 16755
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
637 S KERR AVE, Wilmington, NC 28403
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Other Identifiers 4

Medicaid8902701NC
Medicare UPINC80602
Other02701NC · Bcbs Nc
Medicare ID-Type Unspecified230261NC

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SOUTHEASTERN MEDICAL GROUP, P.A.
Internal Medicine
637 S KERR AVE
WILMINGTON, NC 28403
New Hanover County (910) 799-1810
MR. ALAN EFIRD THOMAS M.D.
Internal Medicine
637 S KERR AVE
WILMINGTON, NC 28403
New Hanover County (910) 799-1810

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jack Wilson's NPI number?

The NPI number for Jack Wilson is 1356349559. It was assigned to this individual provider in the NPPES registry on July 12, 2005.

Where is Jack Wilson located?

Jack Wilson practices at 637 S Kerr Ave, Wilmington, NC 28403. The listed phone number is (910) 799-1810.

What is Jack Wilson's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

When was this NPI record last updated?

The NPPES record for Jack Wilson was last updated on September 20, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.