Individual
BRIAN CRANFORD WILDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1322 ELTON RD, SUITE H, JENNINGS, LA 70546-4100
(337) 246-7200
(337) 246-7202
Mailing address
501 DR MICHAEL DEBAKEY DR, LAKE CHARLES, LA 70601-5724
(337) 312-8360
(337) 312-6708
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
022802
LA
Other
Enumeration date
10/03/2006
Last updated
02/03/2017
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