Individual
DR. CHARLES WILCOX DANIEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
12525 PERKINS RD, SUITE C, BATON ROUGE, LA 70810-1907
(225) 769-2003
(225) 767-3055
Mailing address
5959 S SHERWOOD FOREST BLVD, BATON ROUGE, LA 70816-6038
(225) 526-0002
(225) 767-9196
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
015131
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1315541
—
LA
Enumeration date
07/19/2005
Last updated
08/26/2021
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