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General NPI Number Information
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NPI Number | 1811047798
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Entity Type | Organization
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Legal Business Name | WIKOFF UROLOGY, P.A.
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Dates
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Enumeration Date | 01/11/2007
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Last Update Date | 05/01/2008
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Provider Practice Location Address
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Address Line | 2915 N MAIN ST
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City | PARIS
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State | TX
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Zip | 75460-9360
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Country | US
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Telephone | 903-784-4044
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Fax | 903-784-4201
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Provider Business Mailing Address
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Address Line | 2915 N MAIN ST
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City | PARIS
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State | TX
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Zip | 75460-9360
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Country | US
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Telephone | 903-784-4044
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Fax | 903-784-4201
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DONALD LEE WIKOFF
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Credential | M.D.
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Telephone | 903-784-4044
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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 | H6983
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License Number State | TX
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