Doctor Name: | CHARLIE WILKES |
NPI Number: | 1407022551 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | 053232301 |
Business Practice Address: | 2323 Hudson Rivers Church Rd Danielsville, GA - 306332740 |
Business Phone Number: | 7067892408 |
Business Fax Number: | 7067892857 |
Mailing Address: | 2323 Hudson Rivers Church Rd, DANIELSVILLE |
State: | GA |
Postal Code: | 306332740 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 05/07/2008 |
NPI Last Update Date: | 05/07/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 172A00000X |
License Number: | 053232301 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Driver |
Taxonomy Specialization: | |
Taxonomy Definition: | A person employed to operate a motor vehicle as a carrier of persons or property. |