Organization
LEROY A WILSON M D P C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LEROY AUGUSTUS WILSON M. D. (PRESIDENT)
(404) 659-1234
Entity
Organization
Contact information
Practice address
315 BOULEVARD NE, SUITE 316, ATLANTA, GA 30312
(404) 659-1234
(404) 659-0640
Mailing address
315 BOULEVARD NE, SUITE 316, ATLANTA, GA 30312
(404) 659-1234
(404) 659-0640
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
12594
GA
Other
Enumeration date
05/07/2008
Last updated
05/07/2008
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