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General NPI Number Information
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NPI Number | 1245296060
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Entity Type | Organization
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Legal Business Name | WILLIAM B. WILKINSON, MD PC
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Dates
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Enumeration Date | 04/21/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 523 GANDY ST NE SUITE E
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City | RUSSELLVILLE
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State | AL
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Zip | 35653-1961
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Country | US
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Telephone | 256-331-3339
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Fax | 256-331-3342
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Provider Business Mailing Address
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Address Line | PO BOX 1203
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City | RUSSELLVILLE
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State | AL
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Zip | 35653-1203
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Country | US
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Telephone | 256-331-3339
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Fax | 256-331-3342
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Authorized Official
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Title or Position | CEO/PHYSICIAN
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Name | WILLIAM B. WILKINSON
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Credential | MD
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Telephone | 256-331-3339
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 20102
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License Number State | AL
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