Randall Mark Wilk, MDDDSPHD
Randall Mark Wilk, MDDDSPHD is a Maxillofacial Surgery in Gretna, Louisiana. Graduated from Louisiana State University School of Medicine in New Orleans in 1995, 31 years ago. Practices as a sole proprietor and accepts Medicare assignment. Licensed in Louisiana.
- Years since qualifying
- 31
- Trained at
- Louisiana State University School of Medicine in New Orleans
- Licensed in
- LA
- In the registry since
- 2006
- Specialties on file
- 2
Practice location Address checks out
120 Meadowcrest St Ste 300Gretna, LA 70056
Phone: (504) 362-6135
Fax: (504) 362-6134
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Oral & Maxillofacial Surgery (D.M.D.) (primary) | Taxonomy 204E00000X · Licence 022962 (LA) |
|---|---|
| Oral and Maxillofacial Surgery (Dentist) | Taxonomy 1223S0112X · Licence 4669 (LA) |
Record details
| NPI number | 1669578944 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Credentials | MDDDSPHD |
| Sole proprietor | Yes |
| NPI enumerated | September 15, 2006 |
| Last updated in NPPES | April 22, 2013 |
| Mailing address | 120 Meadowcrest St., Suite 300, Gretna, LA 70056 |
Medicare enrollment
| Medicare specialty | MAXILLOFACIAL SURGERY |
|---|---|
| Also practises | SURGICAL ONCOLOGY |
| Medical school | LOUISIANA STATE UNIVERSITY SCHOOL OF MEDICINE IN NEW ORLEANS |
| Graduated | 1995 (31 years in practice) |
| Accepts Medicare assignment | Yes — accepts the Medicare-approved amount |
Other providers in Gretna
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Randall M. Wilk, MD, DDS, PHD, APMC
120 Meadowcrest St #300, Gretna, LA 70056 · (504) 362-6135