ALVAH TYSON WICKBOLDT

NEW ORLEANS, LA
NPI1083971006
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy208VP0000X 
(Licence: LA  305062)
Additional Taxonomies390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date2012-04-15
Last Update Date2022-07-21
Business Address
-- ALVAH TYSON WICKBOLDT M.D.
1514 JEFFERSON HWY BRENT HOUSE ROOM 634
NEW ORLEANS, LA 70121-2429
Phone number: 504-842-3000
Mailing Address
-- ALVAH TYSON WICKBOLDT M.D.
1514 JEFFERSON HIGHWAY
NEW ORLEANS, LA 70121-2429
Phone number: 504-842-3000
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