Healthcare Provider Details

I. General information

NPI: 1053781419
Provider Name (Legal Business Name): STEVE LEE WILKERSON PA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2015
Last Update Date: 04/15/2024
Certification Date: 04/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 TUNNEL RD
ASHEVILLE NC
28805-2576
US

IV. Provider business mailing address

1100 TUNNEL RD
ASHEVILLE NC
28805-2576
US

V. Phone/Fax

Practice location:
  • Phone: 828-298-7911
  • Fax:
Mailing address:
  • Phone: 828-278-7911
  • Fax: 828-659-5282

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number0010-05973
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: