Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081P2900X | Pain Medicine | 18847 | SC |
NPI | 1255401782 |
---|---|
Provider Name | Jeffrey C. Wilkins |
First Address | Murrells Inlet, SC 29576-6459 |
Second Address | Murrells Inlet, SC 29576-6459 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/11/2006 |
Last Update Date | 02/05/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G28686 | (02) | SC |