Provider Demographics
NPI:1912253287
Name:WILKINS, MONICA J (MD)
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:J
Last Name:WILKINS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 1ST ST
Mailing Address - Street 2:
Mailing Address - City:ALAMOGORDO
Mailing Address - State:NM
Mailing Address - Zip Code:88310-6517
Mailing Address - Country:US
Mailing Address - Phone:575-446-5801
Mailing Address - Fax:575-446-5826
Practice Address - Street 1:1112 N MAIN ST
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:NM
Practice Address - Zip Code:88201-5010
Practice Address - Country:US
Practice Address - Phone:575-627-4200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-24
Last Update Date:2025-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMMD2019-0999207Q00000X
PAMD462203207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMMD2019-0999OtherNM LICENSE