Provider Demographics
NPI:1386719805
Name:WILKINSON, JAMES S (M D)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:S
Last Name:WILKINSON
Suffix:
Gender:M
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4917 S CROATAN HWY
Mailing Address - Street 2:UNIT 1B
Mailing Address - City:NAGS HEAD
Mailing Address - State:NC
Mailing Address - Zip Code:27959-8811
Mailing Address - Country:US
Mailing Address - Phone:252-261-4187
Mailing Address - Fax:252-261-5182
Practice Address - Street 1:4917 S CROATAN HWY
Practice Address - Street 2:UNIT 1B
Practice Address - City:NAGS HEAD
Practice Address - State:NC
Practice Address - Zip Code:27959-8811
Practice Address - Country:US
Practice Address - Phone:252-261-4187
Practice Address - Fax:252-261-5182
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2016-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC29449207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8987606Medicaid
NC0751030001Medicare NSC
NC8987606Medicaid
NC211549DMedicare PIN