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1396189296
ELIZABETH S. WILD
SHREVEPORT, LA
NPI
1396189296
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
207T00000X Neurological Surgery
(Licence: MI 4301502104)
Enumeration Date
2013-04-22
Last Update Date
2020-07-01
Business Address
ELIZABETH S. WILD MD, MS
1501 KINGS HWY NEUROSURGERY
SHREVEPORT, LA 71103-4228
Phone number: 318-813-2482
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Mailing Address
ELIZABETH S. WILD MD, MS
1501 KINGS HWY NEUROSURGERY
SHREVEPORT, LA 71103-4228
Phone number: 318-813-2482
Copy
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