MEDICARE: JANA L WILKINS D.O.

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	207Q00000X	Family Medicine Physician	4129	OK

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	:	1629063102
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JANA L WILKINS D.O.

Provider Business Mailing Address
First Line	:	1923S UTICA AVE
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74104-6520
Country	:	US
Telephone Number	:	918-744-2946
Fax Number	:

Provider Business Practice Location Address
First Line	:	3400 E FRANK PHILLIPS BLVD
Second Line	:	SUITE 401
City	:	BARTLESVILLE
State	:	OK
Zip	:	74006-2495
Country	:	US
Telephone Number	:	918-331-2445
Fax Number	:	918-331-2498

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

Provider Enumeration Date	:	09/12/2005
Last Update Date	:	10/06/2015

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