MEDICARE: WILLIAM B. WILKINSON, MD PC

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	174400000X	Specialist	20102	AL

Other Identifiers

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

General Provider Information

NPI Number	:	1245296060
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WILLIAM B. WILKINSON, MD PC

Provider Business Mailing Address
First Line	:	PO BOX 1203
Second Line	:
City	:	RUSSELLVILLE
State	:	AL
Zip	:	35653-1203
Country	:	US
Telephone Number	:	256-331-3339
Fax Number	:	256-331-3342

Provider Business Practice Location Address
First Line	:	523 GANDY ST NE
Second Line	:	SUITE E
City	:	RUSSELLVILLE
State	:	AL
Zip	:	35653-1961
Country	:	US
Telephone Number	:	256-331-3339
Fax Number	:	256-331-3342

Authorized Official
Title or Position	:	CEO/PHYSICIAN
Name	:	WILLIAM B. WILKINSON
Credential	:	MD
Telephone Number	:	256-331-3339

Provider Enumeration Date	:	04/21/2006
Last Update Date	:	08/22/2020

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