| Dr Timothy M Wilson Jr, MD | |
| 710 Dewitt Dr, Lugoff, SC 29078-9069 | |
| (803) 438-1806 | |
| Not Available | 
| Full Name | Dr Timothy M Wilson Jr | 
|---|---|
| Gender | Male | 
| Speciality | Family Medicine | 
| Location | 710 Dewitt Dr, Lugoff, South Carolina | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1548843873 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 207Q00000X | Family Medicine | 86187 (South Carolina) | Primary | 
| Entity Name | Self Medical Group | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1982836847 PECOS PAC ID: 6002953916 Enrollment ID: O20091027000071 | 
| Entity Name | Musc Community Physicians | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1841878006 PECOS PAC ID: 6507260668 Enrollment ID: O20210811002388 | 
| Mailing Address | Practice Location Address | 
|---|---|
| Dr Timothy M Wilson Jr, MD Po Box 23321, New York, NY 10087 Ph: () - | Dr Timothy M Wilson Jr, MD 710 Dewitt Dr, Lugoff, SC 29078-9069 Ph: (803) 438-1806 | 
| James C Kearse Iii, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 710 Dewitt Dr, Lugoff, SC 29078 Phone: 803-438-7566 Fax: 803-438-4371 | |
| Dr. Joel Richard Oliver, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 1060 Highway 1 S, Lugoff, SC 29078 Phone: 803-438-9759 Fax: 803-438-9783 | |
| Min Kang, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 710 Dewitt Dr, Lugoff, SC 29078 Phone: 803-438-1806 Fax: 803-438-4371 | |
| Patrice L High, D.O. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 40 Baldwin Ave, Lugoff, SC 29078 Phone: 803-408-3262 Fax: 803-408-8895 |