RANDALL MARK WILK MD DDS PHD NPI 1669578944

NPI Details

Randall Mark Wilk, MD DDS PHD is an oral maxillofacial surgery in Gretna, LA with 31 years of experience. The provider is oral and maxillofacial surgeons are trained to recognize and treat a wide spectrum of diseases, injuries and defects in the head, neck, face, jaws and the hard and soft tissues of the oral and maxillofacial region. They are also trained to administer anesthesia, and provide care in an office setting. They are trained to treat problems such as the extraction of wisdom teeth, misaligned jaws, tumors and cysts of the jaw and mouth, and to perform dental implant surgery. Randall Mark Wilk, MD DDS PHD NPI is 1669578944. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: LOUISIANA STATE UNIVERSITY SCHOOL OF MEDICINE IN NEW ORLEANS
Graduation Year:1995

The provider's business location address is:

120 MEADOWCREST ST.
SUITE 300
GRETNA, LA
ZIP 70056
Phone: (504) 362-6135
Fax: (504) 362-6134

The NPI 1669578944 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 9/15/2006 and was last updated on 4/22/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available: