Individual
ELIZABETH S. WILD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD, MS
Contact information
Practice address
1501 KINGS HWY, NEUROSURGERY, SHREVEPORT, LA 71103-4228
(318) 813-2482
(318) 813-2491
Mailing address
1501 KINGS HWY, NEUROSURGERY, SHREVEPORT, LA 71103-4228
(318) 813-2482
(318) 813-2491
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
4301502104
MI
Other
Enumeration date
04/22/2013
Last updated
07/01/2020
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