Individual
DR. LALAN SCOTT WILFONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8220 WALNUT HILL LN, SUITE 700, PROFESSIONAL BUILDING II, DALLAS, TX 75231-4427
(214) 739-4175
(214) 987-4161
Mailing address
PO BOX 911230, DALLAS, TX 75391-1230
(972) 997-8000
(972) 437-9605
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
K5744
TX
207RX0202X
Medical Oncology Physician
K5744
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
158076301
—
TX
05
—
158076302
—
TX
05
—
158076304
—
TX
05
—
200235410A
—
OK
01
—
8R1590
BLUE CROSS OF TEXAS
TX
Enumeration date
06/02/2006
Last updated
04/07/2009
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