Terry Roger Wilson, PA is a medicare enrolled "Physician Assistant" provider in Monroe, Louisiana. His current practice location is
920 Oliver Rd, Monroe, Louisiana. You can reach out to his office (for appointments etc.) via phone at
(318) 812-7559.
Terry Roger Wilson is licensed to practice in Louisiana (license number 200134) 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 1235188301.
Healthcare Provider's Profile
Full Name | Terry Roger Wilson |
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Gender | Male |
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Speciality | Physician Assistant |
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Location | 920 Oliver Rd, Monroe, 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: 1235188301
- Provider Enumeration Date: 05/08/2006
- Last Update Date: 06/13/2019
Medicare PECOS Information:
- PECOS PAC ID: 9830285402
- Enrollment ID: I20071011000558
Medical Identifiers
Medical identifiers for Terry Roger Wilson such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1235188301 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
225X00000X | Occupational Therapist | OTT.Z11857 (Louisiana) | Secondary |
363A00000X | Physician Assistant | 200134 (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. Terry Roger Wilson 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 |
Terry Roger Wilson, PA 130 Desiard St, Suite 355, Monroe, LA 71201-7319 Ph: (318) 807-7875 | Terry Roger Wilson, PA 920 Oliver Rd, Monroe, LA 71201-5702 Ph: (318) 812-7559 |
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