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:
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Health care specialties

SpecialtyCodeLicense #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 14 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.

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Identifiers

StateTypeNumberIssuer
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

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