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NPI Code Detail

MEDICARE: SARAH WILKS M.D.

MEDICARE: SARAH WILKS 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
1208000000XPediatrics Physician204850LA

Other Identifiers

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

General Provider Information

NPI Number : 1497912521
Entity Type Code : Individual
Provider Name (Legal Business Name) : SARAH WILKS M.D.
Provider Business Mailing Address
First Line : 1702 N BURNSIDE AVE STE C
Second Line :
City : GONZALES
State : LA
Zip : 70737-2141
Country : US
Telephone Number : 225-765-5500
Fax Number : 225-644-0341
Provider Business Practice Location Address
First Line : 1702 N BURNSIDE AVE STE C
Second Line :
City : GONZALES
State : LA
Zip : 70737-2141
Country : US
Telephone Number : 225-765-5500
Fax Number : 225-644-0341
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/16/2008
Last Update Date : 05/20/2021

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