Doctor Name: | DR. JAMES EDWARD WILKERSON |
NPI Number: | 1083934632 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M. D. |
License Number: | |
Business Practice Address: | 4000 Richards Rd Suite B North Little Rock, AR - 721172650 |
Business Phone Number: | 5012553995 |
Business Fax Number: | 5019070623 |
Mailing Address: | 4000 Richards Rd, Suite B NORTH LITTLE ROCK |
State: | AR |
Postal Code: | 721172650 |
Phone Number: | 5012553995 |
Fax Number: | 5019070623 |
NPI Enumeration Date: | 06/06/2010 |
NPI Last Update Date: | 07/01/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |