Individual
MR. WILLIAM J WILDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
12 PROFESSIONAL DRIVE, HOUMA, LA 70360
(985) 868-1810
(985) 876-3670
Mailing address
12 PROFESSIONAL DRIVE, HOUMA, LA 70360
(985) 868-1810
(985) 876-3670
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
011220
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
119241
—
LA
Enumeration date
04/11/2006
Last updated
04/27/2010
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