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NPI 1558455469

NPI 1558455469 : TOLBERT S. WILKINSON MD : SAN ANTONIO, TX

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General NPI Number Information
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    NPI Number           |    1558455469
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    Entity Type          |    Individual 
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    Provider Name        |    TOLBERT S. WILKINSON MD
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    10/03/2006
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    Last Update Date     |    05/29/2015
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Provider Practice Location Address
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    Address Line         |    109 GALLERY CIR SUITE 127
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    City                 |    SAN ANTONIO
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    State                |    TX
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    Zip                  |    78258-3327
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    Country              |    US
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    Telephone            |    210-495-8825
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    Fax                  |    210-495-7145
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Provider Business Mailing Address
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    Address Line         |    109 GALLERY CIR SUITE 127
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    City                 |    SAN ANTONIO
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    State                |    TX
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    Zip                  |    78258-3327
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    Country              |    US
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    Telephone            |    210-495-8825
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    Fax                  |    210-495-7145
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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        |    174400000X
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    Taxonomy Name        |    Specialist
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    License Number       |    D8842
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    License Number State |    TX
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Taxonomy #2
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    Taxonomy Code        |    208600000X
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    Taxonomy Name        |    Surgery Physician
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    License Number       |    D8842
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    License Number State |    TX
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