Individual
DR. WILTON LEE BERGERON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M. D.
Contact information
Practice address
1505 WESTGATE RD, LAFAYETTE, LA 70506-2742
(337) 981-2588
Mailing address
1505 WESTGATE RD, LAFAYETTE, LA 70506-2742
(337) 981-2588
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
8170
LA
Other
Enumeration date
12/23/2009
Last updated
12/23/2009
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