Healthcare Provider Details

I. General information

NPI: 1982568192
Provider Name (Legal Business Name): WILKINS EYECARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2025
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2021 MAPLEWOOD COMMONS DR
MAPLEWOOD MO
63143-1003
US

IV. Provider business mailing address

402 LYNWOOD FOREST DR
MANCHESTER MO
63021-5511
US

V. Phone/Fax

Practice location:
  • Phone: 314-860-2020
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: DR. MARK WILKINS
Title or Position: OPTOMETRIST
Credential: OD
Phone: 314-591-7887