Individual
WILTON MARSALIS
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2301 S LAMAR BLVD, OXFORD, MS 38655-5373
(334) 386-2053
(334) 244-1830
Mailing address
PO BOX 235022, MONTGOMERY, AL 36123-5022
(334) 386-2053
(334) 244-1830
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
08769
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00124070
—
MS
01
—
P00076163
RAILROAD PROV #
MS
Enumeration date
05/18/2006
Last updated
07/09/2007
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