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General NPI Number Information
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NPI Number | 1245274331
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Entity Type | Individual
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Provider Name | ANNE E WILKERSON M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/16/2006
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Last Update Date | 11/27/2012
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Provider Practice Location Address
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Address Line | 3010 WILLIAMS DR SUITE 210
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City | GEORGETOWN
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State | TX
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Zip | 78628-2764
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Country | US
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Telephone | 512-368-4944
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Fax | 512-869-0964
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Provider Business Mailing Address
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Address Line | 101 COLORADO ST APT 2207
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City | AUSTIN
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State | TX
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Zip | 78701-4103
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Country | US
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Telephone | 805-305-3863
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ZP0101X
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Taxonomy Name | Anatomic Pathology Physician
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License Number | A92649
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207ND0900X
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Taxonomy Name | Dermatopathology Physician
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License Number | P1714
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License Number State | TX
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