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NPI Code Detail

MEDICARE: BOBBY S WILKERSON M.D.

MEDICARE: BOBBY S WILKERSON 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
1207RH0003XHematology & Oncology Physician17599MS

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
27271728OTHERMSAETNA US HEALTHCARE

General Provider Information

NPI Number : 1245212844
Entity Type Code : Individual
Provider Name (Legal Business Name) : BOBBY S WILKERSON M.D.
Provider Business Mailing Address
First Line : 1227 N STATE ST
Second Line : SUITE 101
City : JACKSON
State : MS
Zip : 39202-2002
Country : US
Telephone Number : 601-355-2485
Fax Number : 601-353-1463
Provider Business Practice Location Address
First Line : 1227 N STATE ST
Second Line : SUITE 101
City : JACKSON
State : MS
Zip : 39202-2002
Country : US
Telephone Number : 601-355-2485
Fax Number : 601-353-1463
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/18/2005
Last Update Date : 05/24/2017

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Directions to “ BOBBY S WILKERSON M.D.” Practice Location

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