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General NPI Number Information
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NPI Number | 1942321138
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Entity Type | Individual
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Provider Name | CRAIG A WILKES DPM
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Gender | Male
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Dates
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Enumeration Date | 04/03/2007
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Last Update Date | 01/07/2010
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Provider Practice Location Address
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Address Line | 9692 SWAN LAKE DR
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City | GRANITE BAY
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State | CA
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Zip | 95746-6605
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Country | US
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Telephone | 916-435-5200
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Fax | 916-435-5231
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Provider Business Mailing Address
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Address Line | P.O. BOX 2288
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City | ROCKLIN
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State | CA
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Zip | 95677-2228
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Country | US
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Telephone | 916-435-5200
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Fax | 916-435-5231
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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 | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | E3432
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License Number State | CA
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