Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | 15588 | OH |
NPI | 1154539682 |
---|---|
Provider Name | Dr. Don R. Wilkins |
First Address | Reynoldsburg, OH 43068-2307 |
Second Address | Reynoldsburg, OH 43068-2307 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2007 |
Last Update Date | 08/07/2007 |