MEDICARE: DR. NEIL L WILKEY 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	2084P0800X	Psychiatry Physician	4301081313	MI

General Provider Information

NPI Number	:	1730123746
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NEIL L WILKEY MD

Provider Business Mailing Address
First Line	:	2920 DIVISION ST
Second Line	:
City	:	SAINT JOSEPH
State	:	MI
Zip	:	49085-2437
Country	:	US
Telephone Number	:	269-982-7844
Fax Number	:	269-982-1783

Provider Business Practice Location Address
First Line	:	443 CO- 105
Second Line	:
City	:	PALMER LAKE
State	:	CO
Zip	:	80133
Country	:	US
Telephone Number	:	719-602-0914
Fax Number	:

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

Provider Enumeration Date	:	06/16/2006
Last Update Date	:	10/07/2024

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