Individual
EVERETT MICHAEL WILKERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH, D.PHARM
Contact information
Practice address
6652 YOUREE DR, SHREVEPORT, LA 71105-4630
(318) 795-0506
Mailing address
1033 ABBIE GLENN LN, SHREVEPORT, LA 71106-7793
(318) 218-0218
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
011268
LA
Other
Enumeration date
08/26/2013
Last updated
08/26/2013
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