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General NPI Number Information
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NPI Number | 1821420100
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Entity Type | Individual
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Provider Name | JERRUND THOMAS WILKERSON RPH
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Gender | Male
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Dates
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Enumeration Date | 08/08/2013
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Last Update Date | 08/08/2013
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Provider Practice Location Address
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Address Line | 303 PERIMETER CTR N SUITE 300
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City | ATLANTA
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State | GA
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Zip | 30346-3402
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Country | US
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Telephone | 770-329-5757
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Fax | 770-594-9108
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Provider Business Mailing Address
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Address Line | 303 PERIMETER CTR N SUITE 300
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City | ATLANTA
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State | GA
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Zip | 30346-3402
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Country | US
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Telephone | 770-329-5757
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Fax | 770-594-9108
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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 | 1835P1200X
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Taxonomy Name | Pharmacotherapy Pharmacist
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License Number | RPH019148
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 1835P1200X
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Taxonomy Name | Pharmacotherapy Pharmacist
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License Number | PS16182
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 1835P1200X
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Taxonomy Name | Pharmacotherapy Pharmacist
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License Number | 9548
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License Number State | AL
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