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Individual

KATHRYN G WILD

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
4315 HOUMA BLVD, SUITE 500, METAIRIE, LA 70006-2940
(504) 885-8563
(504) 455-1072
Mailing address
4315 HOUMA BLVD, SUITE 500, METAIRIE, LA 70006-2940
(504) 885-8563
(504) 455-1072

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
022400
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1493414
LA
Enumeration date
03/23/2006
Last updated
07/08/2007
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