Wilt, Stephen R.
Wilt, Stephen R. is an sole proprietor health care provider with primary practice located at 4809 Ambassador Caffery Pkwy Suite 100, Lafayette LA 70508-8800. He recently has only one registered license in Allopathic & Osteopathic Physicians / Radiation Oncology, which is considered as his primary health care specialty. Wilt, Stephen R. can be contacted via phone (337) 769-8660.Contact Information
Primary practice address
4809 Ambassador Caffery Pkwy Suite 100
Lafayette LA 70508-8800
Phone: (337) 769-8660
Fax: (337) 769-8661
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Radiation Oncology | 2085R0001X | 10351R | Louisiana |
Profile Details
| NPI number | 1528082443 |
|---|---|
| LBN Legal business name | Wilt, Stephen R. |
| Credentials | M.D., PH.D. |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 26th, 2006 |
| Last updated | Jun 29th, 2020 - about 6 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 | 1528082443 | NPPES |
| Louisiana | Other | 10351R | STATE MEDICAL LICENSE |
| Louisiana | MEDICAID | 1986739 | STATE MEDICAL LICENSE |
| Louisiana | Other | PTAN 381631ZLAC | STATE MEDICAL LICENSE |
| Louisiana | Other | 5DX68 | STATE MEDICAL LICENSE |
| Louisiana | Other | 5U307DX68 | STATE MEDICAL LICENSE |
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