Provider Demographics
NPI:1215524269
Name:WILKINS, TROY RIIS JR
Entity type:Individual
Prefix:MR
First Name:TROY
Middle Name:RIIS
Last Name:WILKINS
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:307 STERLING BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29212-1944
Mailing Address - Country:US
Mailing Address - Phone:803-862-9395
Mailing Address - Fax:
Practice Address - Street 1:307 STERLING BRIDGE RD
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29212-1944
Practice Address - Country:US
Practice Address - Phone:803-862-9395
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-23
Last Update Date:2020-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC146L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, Paramedic