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NPI Code Detail

MEDICARE: DR. LOUISE WILKINSON DO

MEDICARE: DR. LOUISE WILKINSON DO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207P00000XEmergency Medicine Physician36687MO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
326D0446923OTHERMOCLIA

General Provider Information

NPI Number : 1992743777
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LOUISE WILKINSON DO
Provider Business Mailing Address
First Line : 1333 S SAM HOUSTON BLVD
Second Line :
City : HOUSTON
State : MO
Zip : 65483-2046
Country : US
Telephone Number : 417-967-3311
Fax Number : 417-967-1259
Provider Business Practice Location Address
First Line : 1333 S SAM HOUSTON BLVD
Second Line :
City : HOUSTON
State : MO
Zip : 65483-2046
Country : US
Telephone Number : 417-967-3311
Fax Number : 417-967-1259
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/03/2006
Last Update Date : 04/02/2012

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Directions to “ DR. LOUISE WILKINSON DO” Practice Location

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