Leroy A Wilson M D P C in Atlanta - Clinic/center
Leroy A Wilson M D P C - NPI 1225204480
Leroy A Wilson M D P C is a Clinic/center in Atlanta, Georgia. Leroy A Wilson M D P C practices all healthcare services and medical treatments related to Clinic/center. The NPI Number for Leroy A Wilson M D P C is 1225204480. The last update date is 2008-05-07.
Leroy A Wilson M D P C's current location address is 315 Boulevard Ne, Atlanta, Georgia. You can contact this provider via phone number 4046591234 and fax number 4046590640. The mailing address for Leroy A Wilson M D P C is 315 Boulevard Ne, Atlanta, Georgia. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Leroy A Wilson M D P C |
|---|---|
| Address | 315 Boulevard Ne, Atlanta, Georgia |
| Phone Number | 4046591234 |
| Fax Number | 4046590640 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | PRESIDENT |
|---|---|
| Authorized Official Name | Wilson Augustus Leroy |
| Credentials | M. D. |
| Telephone Number | 4046591234 |
NPI Number Detail
| NPI Number | 1225204480 |
|---|---|
| Provider Enumeration Date | 2008-05-07 |
| Last Updated Date | 2008-05-07 |
Provider Mailing Address Detail
| Address | 315 Boulevard Ne |
|---|---|
| City | Atlanta |
| State | Georgia (GA) |
| Post Code | 30312 |
| Phone Number | 4046591234 |
| Fax Number | 4046590640 |
Provider's Primary Taxonomy Detail
| Speciality | Clinic/center |
|---|---|
| Taxonomy | 261Q00000X |
| Licence No | 12594 |
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Definition: A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g |
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What is the Leroy A Wilson M D P C's 1225204480?
The Leroy A Wilson M D P C's NPI (National Provider Identifier) Number is 1225204480. This unique 10-digit identification number is assigned to health care providers by the Centers for Medicare & Medicaid Services (CMS).
Where is the Leroy A Wilson M D P C located?
The Leroy A Wilson M D P C is located at 315 Boulevard Ne, Atlanta, GA 30312.
What is Leroy A Wilson M D P C's primary area of medical expertise, and what taxonomy classification code corresponds to this specialized field?
The primary area of medical expertise for Leroy A Wilson M D P C is Clinic/center, and the corresponding taxonomy classification code for this specialized field is 261Q00000X.
On what date did the Leroy A Wilson M D P C receive its 1225204480 assignment from the Centers for Medicare & Medicaid Services?
The Leroy A Wilson M D P C was assigned its 1225204480 by the Centers for Medicare & Medicaid Services on 2008-05-07.
As of what date were the details pertaining to Leroy A Wilson M D P C last refreshed?
The information related to the Leroy A Wilson M D P C, including its address, specialty, and other relevant details, was last updated on 2008-05-07.