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Organization
PAUL S WILSON MD LLC
Active
Organization
PAUL S WILSON MD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL S WILSON MD (MEMBER)
(318) 455-8841
Entity
Organization
Contact information
Practice address
595 UNADILLA ST, SHREVEPORT, LA 71106-1239
(318) 455-8841
Mailing address
595 UNADILLA ST, SHREVEPORT, LA 71106-1239
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
NULL
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
12/09/2020
Last updated
02/25/2021
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