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General NPI Number Information
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NPI Number | 1447513106
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Entity Type | Organization
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Legal Business Name | JOHN J WILKINS,D.O.,P.A.
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Dates
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Enumeration Date | 06/19/2012
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Last Update Date | 06/19/2012
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Provider Practice Location Address
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Address Line | 239 TAUNTON BLVD A-2
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City | MEDFORD
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State | NJ
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Zip | 08055-3471
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Country | US
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Telephone | 856-983-5551
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Fax | 856-983-1511
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Provider Business Mailing Address
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Address Line | 239 TAUNTON BLVD A-2
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City | MEDFORD
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State | NJ
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Zip | 08055-3471
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Country | US
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Telephone | 856-983-5551
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Fax | 856-983-1511
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOHN WILKINS
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Credential | D.O.
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Telephone | 856-983-5551
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 25MB05076500
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License Number State | NJ
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