Provider Demographics
NPI:1386922490
Name:WILKERSON, LEONARD ALAN (DO, MBA, MPH)
Entity type:Individual
Prefix:
First Name:LEONARD
Middle Name:ALAN
Last Name:WILKERSON
Suffix:
Gender:M
Credentials:DO, MBA, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:212 RIVINGTON WAY
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27455-9329
Mailing Address - Country:US
Mailing Address - Phone:336-558-8501
Mailing Address - Fax:
Practice Address - Street 1:1591 YANCEYVILLE ST STE 100
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27405-6942
Practice Address - Country:US
Practice Address - Phone:336-540-7393
Practice Address - Fax:877-538-5389
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC200201641207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine