William Mabry Wilder MD

NPI 1063522027 - Internal Medicine - 207RG0100X

NPI Details
NPI 1063522027
Gender Male
Enumeration Date 08/30/2006
Last Updated 07/08/2007
Entity Type Individual
Active Over 10 years ago
Practice Location
510 E STONER AVE
SHREVEPORT LA, 71101-4243, US
Phone (318) 221-8411
Fax
Business Location
467 RAILSBACK ST
SHREVEPORT LA, 71106-7725, US
Phone (318) 797-8689
Fax (318) 797-8691
Toxanomy
Taxonomy Code 207RG0100X
License State Louisiana
License Number 8678
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According to our database, Dr. William Mabry Wilder MD NPI is 1063522027, taxonomy code is 207RG0100X and license number is 8678, license state is located at Louisiana. William Mabry Wilder MD physically located at 510 E Stoner Ave, Shreveport LA, 71101-4243. NPI Number William Mabry Wilder MD has the Individual type.

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1063522027 NPI number is provided on an as is basis without warranty of any kind. 1063522027 is maintained by the National Plan & Provider Enumeration System. The contents of William Mabry Wilder MD are for informational purposes only.