Individual ProviderJames R WilsonDentistDental ProvidersPractice Address1701 Country Club Rd, Jacksonville, NC 28546-6005(910) 346-2345PECOS EnrollmentBased on the most recent information from CMS, provider James R Wilson does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 11:51 AM.Profile DetailsProvider ID1114198629Provider TypeIndividualFull NameWilson, James RTitleDr.CredentialDMD,PAGenderMaleSole ProprietorYesEnumeration Date3/13/2008Last Updated3/13/2008Contact InformationPractice LocationPractice Address1701 Country Club Rd, Jacksonville, NC 28546-6005Phone(910) 346-2345Fax(910) 346-1332Mailing LocationMailing Address1701 Country Club Rd, Jacksonville, NC 28546-6005Phone(910) 346-2345Fax(910) 346-1332Provider TaxonomiesCodeDescriptionLicenseCode1223G0001XPrimaryDescriptionDentistDental ProvidersLicense5464North Carolina