Provider Demographics
NPI:1093985434
Name:WILKINS, RICHARD HARRY (DO)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:HARRY
Last Name:WILKINS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1278 ROOSEVELT TRL
Mailing Address - Street 2:
Mailing Address - City:RAYMOND
Mailing Address - State:ME
Mailing Address - Zip Code:04071-6604
Mailing Address - Country:US
Mailing Address - Phone:207-655-6181
Mailing Address - Fax:207-655-6188
Practice Address - Street 1:1278 ROOSEVELT TRL
Practice Address - Street 2:
Practice Address - City:RAYMOND
Practice Address - State:ME
Practice Address - Zip Code:04071-6604
Practice Address - Country:US
Practice Address - Phone:207-655-6181
Practice Address - Fax:207-655-6188
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-29
Last Update Date:2014-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEDO2302261QM1300X, 2083X0100X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice