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NPI Code Detail

MEDICARE: MS. JANI C WILKERSON D.O.

MEDICARE:  MS. JANI C WILKERSON  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
12084P0800XPsychiatry PhysicianOS 13451FL
22084P0800XPsychiatry Physician02008968AIN

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 : 1720306970
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. JANI C WILKERSON D.O.
Provider Business Mailing Address
First Line : PO BOX 44230
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32231-4230
Country : US
Telephone Number : 904-376-3800
Fax Number : 904-376-3998
Provider Business Practice Location Address
First Line : 820 PRUDENTIAL DR STE 510
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32207
Country : US
Telephone Number : 904-376-3800
Fax Number : 904-376-3998
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/12/2010
Last Update Date : 04/22/2026

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Directions to “ MS. JANI C WILKERSON D.O.” Practice Location

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