Individual
DR. ERICH W WOLF JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D, PH.D
Contact information
Practice address
1614 WOLF CIR, LAKE CHARLES, LA 70605-2348
(337) 478-9653
(337) 474-0988
Mailing address
PO BOX 1786, LAKE CHARLES, LA 70602-1786
(337) 478-9653
(337) 474-0988
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
021935
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1567949
—
LA
01
—
5CA84
GROUP MEDICARE #
LA
Enumeration date
06/24/2005
Last updated
07/22/2010
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