Provider Demographics
NPI:1396719571
Name:WILKINSON, ARTHUR W III (MD)
Entity type:Individual
Prefix:DR
First Name:ARTHUR
Middle Name:W
Last Name:WILKINSON
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 HAND AVE STE R
Mailing Address - Street 2:
Mailing Address - City:ORMOND BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32174-8196
Mailing Address - Country:US
Mailing Address - Phone:386-677-7875
Mailing Address - Fax:386-677-5370
Practice Address - Street 1:1400 HAND AVE STE R
Practice Address - Street 2:
Practice Address - City:ORMOND BEACH
Practice Address - State:FL
Practice Address - Zip Code:32174
Practice Address - Country:US
Practice Address - Phone:386-677-7875
Practice Address - Fax:386-677-5370
Is Sole Proprietor?:No
Enumeration Date:2006-02-15
Last Update Date:2024-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME79499207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL261174100Medicaid
FLME79499OtherMEDICAL LICENSE
FLME79499OtherMEDICAL LICENSE
FLH37443Medicare UPIN