Healthcare Provider Details

I. General information

NPI: 1952166126
Provider Name (Legal Business Name): NEIL WILKEY MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/16/2024
Last Update Date: 01/07/2025
Certification Date: 01/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3210 E WOODMEN RD STE 100
COLORADO SPGS CO
80920-3591
US

IV. Provider business mailing address

3210 E WOODMEN RD STE 100
COLORADO SPGS CO
80920-3591
US

V. Phone/Fax

Practice location:
  • Phone: 954-634-4292
  • Fax:
Mailing address:
  • Phone: 954-634-4292
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207KA0200X
TaxonomyAllergy Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. NEIL WILKEY
Title or Position: SOLE MBR
Credential: MD
Phone: 719-679-7838