Alonzo Wilder, PAC is a medicare enrolled "Physician Assistant" in Livingston, Louisiana. His current practice location is
13960 Florida Blvd, Livingston, Louisiana. You can reach out to his office (for appointments etc.) via phone at
(225) 686-0158.
Alonzo Wilder is licensed to practice in Louisiana (license number A10241) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1881635878.
Provider's Profile
Full Name | Alonzo Wilder |
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Gender | Male |
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Speciality | Physician Assistant |
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Location | 13960 Florida Blvd, Livingston, Louisiana |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1881635878
- Provider Enumeration Date: 06/09/2006
- Last Update Date: 01/27/2009
Medicare PECOS Information:
- PECOS PAC ID: 9234288051
- Enrollment ID: I20090527000071
Medical Identifiers
Medical identifiers for Alonzo Wilder such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1881635878 | NPI | - | NPPES |
1626716 | Medicaid | LA | |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
363A00000X | Physician Assistant | A10241 (Louisiana) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Alonzo Wilder is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Alonzo Wilder, PAC Po Box 261166, Baton Rouge, LA 70826-1166 Ph: () - | Alonzo Wilder, PAC 13960 Florida Blvd, Livingston, LA 70754 Ph: (225) 686-0158 |
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