Wilbon, Miriam J

Wilbon, Miriam J is an sole proprietor health care provider with primary practice located at 3330 Masonic Dr , Alexandria LA 71301-3841. She recently has 4 registered licenses in different health care specialties including Technologists, Technicians & Other Technical Service Providers / Medical Technologist, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Medical, Physician Assistants & Advanced Practice Nursing Providers / Surgical. Physician Assistants & Advanced Practice Nursing Providers / Medical is her primary health care specialty. Wilbon, Miriam J can be contacted via phone (318) 487-1122.

Contact Information

Primary practice address
3330 Masonic Dr Alexandria LA 71301-3841
Phone: (318) 487-1122
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Technologists, Technicians & Other Technical Service Providers / Medical Technologist 246QM0706X G02542 Louisiana
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X A10315 Louisiana
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X A10315 Louisiana
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X A10315 Louisiana

Profile Details

NPI number 1629249347
LBN Legal business name Wilbon, Miriam J
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 20th, 2008
Last updated Feb 22nd, 2017 - about 9 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 1629249347 NPPES
Louisiana MEDICAID 1886203

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