MEDICARE: WILLIAM SCOTT WILKINSON M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207W00000X	Ophthalmology Physician	4301406185	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	4326472	OTHER		AETNA PIN
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	1806316611	OTHER	MI	BCBS OF MICHIGAN PIN
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1124057690
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILLIAM SCOTT WILKINSON M.D.

Provider Business Mailing Address
First Line	:	690 KIMBERLY ST
Second Line	:
City	:	BIRMINGHAM
State	:	MI
Zip	:	48009-1117
Country	:	US
Telephone Number	:	248-646-4082
Fax Number	:

Provider Business Practice Location Address
First Line	:	44555 WOODWARD AVE
Second Line	:	SUITE 203
City	:	PONTIAC
State	:	MI
Zip	:	48341-5033
Country	:	US
Telephone Number	:	248-334-4931
Fax Number	:	248-858-3993

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/30/2006
Last Update Date	:	11/01/2022

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