| Doctor Name: | DR. GINA LYNNE WILSON |
| NPI Number: | 1215908496 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MD |
| License Number: | MD201912 |
| Business Practice Address: | 6300 Main St Lane Regional Medical Center Zachary, LA - 707914037 |
| Business Phone Number: | 2256584335 |
| Business Fax Number: | |
| Mailing Address: | 6457 Province Ln, BATON ROUGE |
| State: | LA |
| Postal Code: | 708083579 |
| Phone Number: | 2254563105 |
| Fax Number: | 2257674608 |
| NPI Enumeration Date: | 01/27/2006 |
| NPI Last Update Date: | 02/02/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2085R0202X |
| License Number: | MD201912 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | LA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Radiology |
| Taxonomy Specialization: | Diagnostic Radiology |
| Taxonomy Definition: | A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |