Provider Demographics
NPI:1497849293
Name:WILSON, FRANK MERCER (MD)
Entity Type:Individual
Prefix:DR
First Name:FRANK
Middle Name:MERCER
Last Name:WILSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 62600
Mailing Address - Street 2:DEPT 1142
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70162-2600
Mailing Address - Country:US
Mailing Address - Phone:210-614-0180
Mailing Address - Fax:210-566-5698
Practice Address - Street 1:4200 HOUMA BLVD
Practice Address - Street 2:EMERGENCY DEPT
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70006-2970
Practice Address - Country:US
Practice Address - Phone:210-614-0180
Practice Address - Fax:210-566-5698
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2011-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA012147207PE0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
LAH4048ZOtherBCBS
LA1131521Medicaid
LAB60563Medicare UPIN
LA930089169Medicare PIN
LA5H110Medicare PIN