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General NPI Number Information
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NPI Number | 1508444084
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Entity Type | Individual
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Provider Name | ZACHARY JOSEPH WILKIE
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Gender | Male
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Dates
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Enumeration Date | 03/29/2021
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Last Update Date | 08/07/2024
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Provider Practice Location Address
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Address Line | 1600 SW ARCHER RD
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City | GAINESVILLE
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State | FL
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Zip | 32610-4486
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Country | US
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Telephone | 352-273-5159
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Fax |
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Provider Business Mailing Address
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Address Line | 1147 NW 64TH TER
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City | GAINESVILLE
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State | FL
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Zip | 32605-4218
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Country | US
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Telephone | 352-333-5152
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | OS21279
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License Number State | FL
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