Healthcare Provider Details

I. General information

NPI: 1760642243
Provider Name (Legal Business Name): JAMES A WILKERSON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2008
Last Update Date: 08/15/2025
Certification Date: 08/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33 SEWALL ST
PORTLAND ME
04102-2603
US

IV. Provider business mailing address

33 SEWALL ST
PORTLAND ME
04102-2603
US

V. Phone/Fax

Practice location:
  • Phone: 207-828-2100
  • Fax:
Mailing address:
  • Phone: 72-828-2100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberMD20174
License Number StateME
# 2
Primary TaxonomyY
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License NumberMD20174
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: