Provider Demographics
NPI:1275889925
Name:JEFFREY SCOTT WILKINS, OD
Entity type:Organization
Organization Name:JEFFREY SCOTT WILKINS, OD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:WILKINS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:919-634-1950
Mailing Address - Street 1:1717 E ASH ST
Mailing Address - Street 2:
Mailing Address - City:GOLDSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27530-4042
Mailing Address - Country:US
Mailing Address - Phone:919-736-4319
Mailing Address - Fax:919-736-4320
Practice Address - Street 1:1717 E ASH ST
Practice Address - Street 2:
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27530-4042
Practice Address - Country:US
Practice Address - Phone:919-736-4319
Practice Address - Fax:919-736-4320
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-31
Last Update Date:2012-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1972152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty