Doctor Name: | TIMOTHY WILKINS |
NPI Number: | 1083091995 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | 347C0000X |
Business Practice Address: | 3235 Gordon Dr Petersburg, VA - 238052658 |
Business Phone Number: | 8049892230 |
Business Fax Number: | 8048621805 |
Mailing Address: | Po Box 1913, PETERSBURG |
State: | VA |
Postal Code: | 238050913 |
Phone Number: | 8048922304 |
Fax Number: | 8048621508 |
NPI Enumeration Date: | 04/29/2015 |
NPI Last Update Date: | 04/29/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 347C00000X |
License Number: | 347C0000X |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VA |
Taxonomy Type: | Transportation Services |
Taxonomy Classification: | Private Vehicle |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual paid to provide non-emergency transportation using their privately owned/leased vehicle. |