=====================================================
General NPI Number Information
=====================================================
NPI Number | 1346210671
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JULIE A. WILKIE M.D.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/26/2006
-----------------------------------------------------
Last Update Date | 05/09/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 688 E MILLSAP RD STE 101
-----------------------------------------------------
City | FAYETTEVILLE
-----------------------------------------------------
State | AR
-----------------------------------------------------
Zip | 72703-3930
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 479-582-3366
-----------------------------------------------------
Fax | 479-582-5843
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 1523
-----------------------------------------------------
City | FAYETTEVILLE
-----------------------------------------------------
State | AR
-----------------------------------------------------
Zip | 72702-1523
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 479-571-6038
-----------------------------------------------------
Fax | 479-582-0222
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207VG0400X
-----------------------------------------------------
Taxonomy Name | Gynecology Physician
-----------------------------------------------------
License Number | E-2540
-----------------------------------------------------
License Number State | AR
-----------------------------------------------------