Doctor Name: | JASON B WILSON |
NPI Number: | 1235132531 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 13062R |
Business Practice Address: | 3424 Medical Park Dr Ste 1 Monroe, LA - 712032378 |
Business Phone Number: | 3183619299 |
Business Fax Number: | 3183243334 |
Mailing Address: | 312 Grammont St, Ste 300 MONROE |
State: | LA |
Postal Code: | 712017403 |
Phone Number: | 3183884030 |
Fax Number: | 3183243334 |
NPI Enumeration Date: | 05/31/2005 |
NPI Last Update Date: | 04/15/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 207V00000X |
License Number: | 13062R |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | LA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Obstetrics & Gynecology |
Taxonomy Specialization: | |
Taxonomy Definition: | An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |