Wilson, Wendall A
Wilson, Wendall A is an individual health care provider with primary practice located at 1501 Kings Hwy Department Of Internal Medicine, Rheumatology Section, Shreveport LA 71103-4228. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Rheumatology. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Wilson, Wendall A can be contacted via phone (318) 675-7737.Contact Information
Primary practice address
1501 Kings Hwy Department Of Internal Medicine, Rheumatology Section
Shreveport LA 71103-4228
Phone: (318) 675-7737
Fax: (318) 675-5666
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 04794R | Louisiana |
| Allopathic & Osteopathic Physicians / Rheumatology | 207RR0500X | 04794R | Louisiana |
Profile Details
| NPI number | 1588690804 |
|---|---|
| LBN Legal business name | Wilson, Wendall A |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 26th, 2006 |
| Last updated | Jul 8th, 2007 - about 18 years ago |
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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1588690804 | NPPES |
| Louisiana | MEDICAID | 1300211 |
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