SearchLouisiana101YP2500X

Jerome Wilson

NPI 1922648674 · on the registry since 2020 · sole proprietor

Practice

Address
100 Diplomat Way
Thibodaux, LA 70301
Phone
(985) 316-6483
Organisation at this address
Wilson Transportation
Inferred from a shared address, not stated in the registry.

Registry record

Primary taxonomy
101YP2500X
101YP2500X
Also registered as
103TF0000X
103TF0000X
Licence states on file
LA
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2020-01-10

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Louisiana