Healthcare Provider Details

I. General information

NPI: 1326332545
Provider Name (Legal Business Name): ROBERT D. WILKINSON D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/06/2011
Last Update Date: 01/25/2024
Certification Date: 01/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5510 S FORT APACHE RD # 465
LAS VEGAS NV
89148-7700
US

IV. Provider business mailing address

5510 S FORT APACHE RD # 465
LAS VEGAS NV
89148-7700
US

V. Phone/Fax

Practice location:
  • Phone: 725-867-8144
  • Fax:
Mailing address:
  • Phone: 725-867-8144
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberDO2278
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License NumberDO2278
License Number StateNV
# 3
Primary TaxonomyY
Taxonomy Code207PP0204X
TaxonomyPediatric Emergency Medicine (Emergency Medicine) Physician
License NumberDO2278
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: