Wilson, Clint N.

Wilson, Clint N. is an individual health care provider with primary practice located at 5341 Airline Dr Ste 130 , Bossier City LA 71111-6710. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Wilson, Clint N. can be contacted via phone (318) 935-1820.

Contact Information

Primary practice address
5341 Airline Dr Ste 130 Bossier City LA 71111-6710
Phone: (318) 935-1820
Fax: (318) 935-1863
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 201780 Louisiana

Profile Details

NPI number 1427269059
LBN Legal business name Wilson, Clint N.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 25th, 2007
Last updated Dec 20th, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1427269059 NPPES
Louisiana MEDICAID 1078409

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