# BRIAN CRANFORD WILDER APMC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1306300298
- **Authorized official:** BRIAN WILDER (OWNER)
- **Authorized official phone:** (337) 246-7200

## Contact information

- **Practice address:** 2539 F E LANDRY RD, JENNINGS, LA 70546-8618
- **Practice address phone:** (337) 991-9276
- **Practice address fax:** (337) 943-0846
- **Mailing address:** 1509 DULLES DR, LAFAYETTE, LA 70506-3718

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 01/25/2019
- **Last updated:** 02/04/2019