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General NPI Number Information
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NPI Number | 1215007836
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Entity Type | Organization
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Legal Business Name | WILKINSON VISION, INC
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Dates
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Enumeration Date | 11/09/2006
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Last Update Date | 06/15/2020
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Provider Practice Location Address
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Address Line | 200 S CHICAGO ST
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City | HOT SPRINGS
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State | SD
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Zip | 57747-2322
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Country | US
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Telephone | 605-745-3175
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Fax | 605-745-4006
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Provider Business Mailing Address
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Address Line | 200 S CHICAGO ST
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City | HOT SPRINGS
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State | SD
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Zip | 57747-2322
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Country | US
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Telephone | 605-745-3175
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Fax | 605-745-4006
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DALLAS CHARLES WILKINSON
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Credential | O.D.
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Telephone | 605-745-3175
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 575
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License Number State | SD
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