| Doctor Name: | KENNETH A WILKINSON |
| NPI Number: | 1457435851 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | 35024770W |
| Business Practice Address: | 207 St Anns Ln Waverly, OH - 456901040 |
| Business Phone Number: | 7407085478 |
| Business Fax Number: | 7409475720 |
| Mailing Address: | 207 St Anns Ln, WAVERLY |
| State: | OH |
| Postal Code: | 456901040 |
| Phone Number: | 7407085478 |
| Fax Number: | 7409475720 |
| NPI Enumeration Date: | 10/24/2006 |
| NPI Last Update Date: | 03/21/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 35024770W |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |