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NPI Code Detail

MEDICARE: PHILLIP K WILKINS JR. PHARMD

MEDICARE: PHILLIP K WILKINS JR. PHARMD
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
1183500000XPharmacist2014021642MO

General Provider Information

NPI Number : 1962131938
Entity Type Code : Individual
Provider Name (Legal Business Name) : PHILLIP K WILKINS JR. PHARMD
Provider Business Mailing Address
First Line : 214 W MAIN ST
Second Line :
City : MALDEN
State : MO
Zip : 63863-2114
Country : US
Telephone Number : 573-276-3784
Fax Number : 573-276-2144
Provider Business Practice Location Address
First Line : 214 W MAIN ST
Second Line :
City : MALDEN
State : MO
Zip : 63863-2114
Country : US
Telephone Number : 573-276-3784
Fax Number : 573-276-2144
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/06/2022
Last Update Date : 06/06/2022

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