MEDICARE: ROBERT G WILKIE MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207P00000X	Emergency Medicine Physician	R4F30	MO
2	207Q00000X	Family Medicine Physician	R4F30	MO

General Provider Information

NPI Number	:	1063457216
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT G WILKIE MD

Provider Business Mailing Address
First Line	:	PO BOX 82
Second Line	:
City	:	MOUNTAIN VIEW
State	:	MO
Zip	:	65548-0082
Country	:	US
Telephone Number	:	417-934-7094
Fax Number	:	417-934-7092

Provider Business Practice Location Address
First Line	:	100 W US HIGHWAY 60
Second Line	:
City	:	MOUNTAIN VIEW
State	:	MO
Zip	:	65548-8542
Country	:	US
Telephone Number	:	417-934-7094
Fax Number	:	417-934-7092

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/19/2006
Last Update Date	:	03/10/2008

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