Individual
DR. CLINT N. WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5341 AIRLINE DR STE 130, BOSSIER CITY, LA 71111-6710
(318) 935-1820
(318) 935-1863
Mailing address
5341 AIRLINE DR STE 130, BOSSIER CITY, LA 71111-6710
(318) 935-1820
(318) 935-1863
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
201780
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1078409
—
LA
Enumeration date
05/25/2007
Last updated
12/20/2023
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