Doctor Name: | ROBERT MARK WILKINS |
NPI Number: | 1023269412 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | 482 |
Business Practice Address: | 404 Mccravy Dr # B Spartanburg, SC - 293033178 |
Business Phone Number: | 8645852246 |
Business Fax Number: | 8645853020 |
Mailing Address: | 404 Mccravy Dr # B, SPARTANBURG |
State: | SC |
Postal Code: | 293033178 |
Phone Number: | 8645852246 |
Fax Number: | 8645853020 |
NPI Enumeration Date: | 10/04/2008 |
NPI Last Update Date: | 10/04/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 156FX1800X |
License Number: | 482 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | SC |
Taxonomy Type: | Eye and Vision Services Providers |
Taxonomy Classification: | Technician/Technologist |
Taxonomy Specialization: | Optician |
Taxonomy Definition: |