MEDICARE: TIMOTHY ANDREW WILKINS

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	152WV0400X	Vision Therapy Optometrist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1619147535
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TIMOTHY ANDREW WILKINS

Provider Business Mailing Address
First Line	:	2331 KERN ST
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93721-2700
Country	:	US
Telephone Number	:	559-264-7799
Fax Number	:

Provider Business Practice Location Address
First Line	:	2331 KERN ST
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93721-2700
Country	:	US
Telephone Number	:	559-264-7799
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. TIMOTHY ANDREW WILKINS
Credential	:	O.D.
Telephone Number	:	559-252-2325

Provider Enumeration Date	:	03/06/2008
Last Update Date	:	05/04/2010

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