Doctor Name: | DR. WILBERT MCCLAY |
NPI Number: | 1942365846 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | 013525 |
Business Practice Address: | 524 N Donmoor Ave Baton Rouge, LA - 708062813 |
Business Phone Number: | 2259281046 |
Business Fax Number: | 2259288499 |
Mailing Address: | 524 North Donmoor Ave, BATON ROUGE |
State: | LA |
Postal Code: | 70806 |
Phone Number: | 2259281046 |
Fax Number: | 2259288499 |
NPI Enumeration Date: | 12/22/2006 |
NPI Last Update Date: | 11/09/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 013525 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | LA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |