Individual
MR. LEONARD C WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
2495 SHREVEPORT HWY BLDG 9, PINEVILLE, LA 71360-4044
(318) 473-0010
(318) 483-5036
Mailing address
PO BOX 69004, ALEXANDRIA, LA 71306-9004
(318) 473-0010
(318) 483-5036
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
NA
—
Other
Enumeration date
08/30/2006
Last updated
07/08/2007
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