Individual
DR. KYLE EDWARD WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1202 S TYLER ST, COVINGTON, LA 70433-2330
(504) 377-7167
Mailing address
931 EMERALD ST, NEW ORLEANS, LA 70124-3522
(504) 377-7167
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
01088212A
IN
207P00000X
Emergency Medicine Physician
Primary
340389
LA
390200000X
Student in an Organized Health Care Education/Training Program
—
IN
Other
Enumeration date
04/06/2021
Last updated
10/18/2024
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