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General NPI Number Information
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NPI Number | 1346832169
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Entity Type | Individual
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Provider Name | WILLIAM JOSEPH WIKOFF NP
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Gender | Male
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Dates
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Enumeration Date | 02/04/2021
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Last Update Date | 08/07/2025
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Provider Practice Location Address
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Address Line | 1199 PRINCE AVE
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City | ATHENS
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State | GA
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Zip | 30606-2797
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Country | US
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Telephone | 706-475-2660
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Fax |
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Provider Business Mailing Address
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Address Line | 1255 FRIENDSHIP RD STE 150
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City | BRASELTON
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State | GA
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Zip | 30517-5618
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Country | US
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Telephone | 770-962-3642
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Fax | 770-962-3643
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | RN289964
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | RN289964
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License Number State | GA
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