Mark Douglas Wilson in Shreveport - Sports Medicine
Mark Douglas Wilson - NPI 1235399163
Mark Douglas Wilson is a Sports Medicine in Shreveport, Louisiana. Mark Douglas Wilson practices all healthcare services and medical treatments related to Sports Medicine. The NPI Number for Mark Douglas Wilson is 1235399163. The last update date is 2015-07-29.
Mark Douglas Wilson's current location address is 186 Colonel A.p. Kouns Dr., Shreveport, Louisiana. You can contact this provider via phone number 5743291445. The mailing address for Mark Douglas Wilson is 186 Colonel A.p. Kouns Dr., Shreveport, Louisiana. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Mark Douglas Wilson |
|---|---|
| Address | 186 Colonel A.p. Kouns Dr., Shreveport, Louisiana |
| Phone Number | 5743291445 |
| Fax Number | |
| Sole Proprietor | N |
| Credentials | M.D. |
NPI Number Detail
| NPI Number | 1235399163 |
|---|---|
| Provider Enumeration Date | 2008-06-13 |
| Last Updated Date | 2015-07-29 |
Provider Mailing Address Detail
| Address | 186 Colonel A.p. Kouns Dr. |
|---|---|
| City | Shreveport |
| State | Louisiana (LA) |
| Post Code | 71115 |
| Phone Number | 5743291445 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Sports Medicine |
|---|---|
| Taxonomy | 207Xx0005X |
| Licence No | MD.204547 |
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Definition: An orthopaedic surgeon trained in sports medicine provides appropriate care for all structures of the musculoskeletal system directly affected by participation in sporting activity. This specialist is proficient in areas including conditioning, train |
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Post Comment/ Review Below
What is the Mark Douglas Wilson's unique identification number?
The Mark Douglas Wilson has been assigned the NPI (National Provider Identifier) Number 1235399163 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for the organization.
Could you provide the complete address where Mark Douglas Wilson is physically located?
The Mark Douglas Wilson is situated at the following address: 186 Colonel A.P. Kouns Dr., Shreveport, LA 71115.
What is Mark Douglas Wilson's specialized field of practice, and what is the corresponding taxonomy classification code?
The Mark Douglas Wilson's area of specialization is Sports Medicine, and the corresponding taxonomy code that categorizes this field of practice is 207Xx0005X.
On what date did Mark Douglas Wilson receive its 1235399163 assignment from the Centers for Medicare & Medicaid Services?
The Mark Douglas Wilson was assigned its 1235399163 on 2008-06-13, which is the date when this unique identifier was issued to the organization by the Centers for Medicare & Medicaid Services.
As of what date were the details pertaining to Mark Douglas Wilson last refreshed?
The information related to the Mark Douglas Wilson, including its address, specialty, and other relevant details, was last updated on 2015-07-29.