Individual
DR. BENJAMIN WADE WILKERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
15837 PAUL VEGA MD DR, HAMMOND, LA 70403-1495
(985) 543-6079
(985) 350-9950
Mailing address
PO BOX 2277, HAMMOND, LA 70404-2277
(985) 543-6079
(985) 350-9950
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
20280
MS
2085R0202X
Diagnostic Radiology Physician
Primary
204533
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03070723
—
MS
05
—
2153498
—
LA
Enumeration date
05/22/2007
Last updated
09/20/2011
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