MEDICARE: ROBERT WILKERSON PLMSW

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	104100000X	Social Worker	PLMSW	AR

General Provider Information

NPI Number	:	1649645359
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT WILKERSON PLMSW

Provider Business Mailing Address
First Line	:	8617 S 15TH ST
Second Line	:
City	:	FORT SMITH
State	:	AR
Zip	:	72908-8539
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8617 S 15TH ST
Second Line	:
City	:	FORT SMITH
State	:	AR
Zip	:	72908-8539
Country	:	US
Telephone Number	:	479-555-1212
Fax Number	:

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

Provider Enumeration Date	:	12/07/2015
Last Update Date	:	02/09/2026

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