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General NPI Number Information
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NPI Number | 1386922490
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Entity Type | Individual
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Provider Name | LEONARD ALAN WILKERSON D.O., MBA, MPH
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Gender | Male
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Dates
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Enumeration Date | 07/25/2011
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 1591 YANCEYVILLE ST STE 100
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City | GREENSBORO
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State | NC
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Zip | 27405-6942
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Country | US
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Telephone | 336-540-7393
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Fax | 877-538-5389
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Provider Business Mailing Address
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Address Line | 212 RIVINGTON WAY
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City | GREENSBORO
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State | NC
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Zip | 27455-9329
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Country | US
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Telephone | 336-558-8501
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 200201641
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License Number State | NC
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