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General NPI Number Information
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NPI Number | 1982601134
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Entity Type | Individual
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Provider Name | RONALD L WILLSON MD
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Gender | Male
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Dates
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Enumeration Date | 07/01/2005
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Last Update Date | 10/08/2025
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Provider Practice Location Address
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Address Line | 1 GALLERIA BLVD STE 900
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City | METAIRIE
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State | LA
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Zip | 70001-7528
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Country | US
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Telephone | 504-456-9061
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Fax | 504-888-6045
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Provider Business Mailing Address
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Address Line | 1 GALLERIA BLVD STE 900
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City | METAIRIE
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State | LA
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Zip | 70001-7528
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Country | US
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Telephone | 504-456-9061
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Fax | 504-888-6045
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 12352R
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 207WX0107X
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Taxonomy Name | Retina Specialist (Ophthalmology) Physician
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License Number | 12352R
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License Number State | LA
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