Radcliff, Lautrec Wilson
Radcliff, Lautrec Wilson is an individual health care provider with primary practice located at 2609 Village Professional Dr Suite 3, Opelika AL 36801-5442. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Nephrology. Allopathic & Osteopathic Physicians / Nephrology is his primary health care specialty. Radcliff, Lautrec Wilson can be contacted via phone (334) 749-6523.Contact Information
Primary practice address
2609 Village Professional Dr Suite 3
Opelika AL 36801-5442
Phone: (334) 749-6523
Fax: (334) 742-0242
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 14179 | Alabama |
| Allopathic & Osteopathic Physicians / Nephrology | 207RN0300X | 14179 | Alabama |
Profile Details
| NPI number | 1801801493 |
|---|---|
| LBN Legal business name | Radcliff, Lautrec Wilson |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 30th, 2006 |
| Last updated | Sep 13th, 2011 - about 15 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1801801493 | NPPES |
| Alabama | Other | 51038111 | BCBS LAFAYETTE |
| Alabama | Other | 51079130 | BCBS LAFAYETTE |
| Alabama | Other | 1801801493 | BCBS LAFAYETTE |
| Alabama | MEDICAID | 528701590 | BCBS LAFAYETTE |
| Alabama | Other | CC1726 | BCBS LAFAYETTE |
| Alabama | Other | 51079131 | BCBS LAFAYETTE |
| Alabama | Other | 51520919 | BCBS LAFAYETTE |
| Alabama | Other | 51079111 | BCBS LAFAYETTE |
| Alabama | Other | 51079203 | BCBS LAFAYETTE |
Popular Providers
-
Nass, Khaled
663 Lanier Park Dr , Gainesville GA 30501-2059 -
Nooruddin, Karim N
5826 Esplanade Dr Ste 204 , Corpus Christi TX 78414-4198 -
Stokes, Thomas Jefferson
2609 Village Professional Dr Suite 3, Opelika AL 36801-5442 -
Ferraro, James C.
6622 N 91St Ave Ste 200 , Glendale AZ 85305-2569 -
Palubiak, David J
2020 Riverside Dr Suite 200, Green Bay WI 54301-2300 -
Yadla, Gautam
121 N 20Th St Ste 20A , Opelika AL 36801-5456 -
Laurel, Edgardo
2545 E Thomas Rd Suite 120, Phoenix AZ 85016-7969 -
Lee, Sungchun
21410 N 19Th Ave Suite 131, Phoenix AZ 85027-2738