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General NPI Number Information
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NPI Number | 1952668626
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Entity Type | Individual
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Provider Name | NICHOLAS TRENT WILKES M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/18/2012
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Last Update Date | 12/05/2019
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Provider Practice Location Address
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Address Line | 3719 DAUPHIN ST
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City | MOBILE
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State | AL
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Zip | 36608
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Country | US
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Telephone | 251-860-5333
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 830674
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City | BIRMINGHAM
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State | AL
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Zip | 35283-0674
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Country | US
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Telephone |
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | MD34104
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License Number State | AL
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