Provider Demographics
NPI:1114906013
Name:WILKINSON, ERIC PETER (MD)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:PETER
Last Name:WILKINSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1209 N. SUMMERBROOK AVE. STE 100
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:ID
Mailing Address - Zip Code:83642
Mailing Address - Country:US
Mailing Address - Phone:208-938-5823
Mailing Address - Fax:208-938-5306
Practice Address - Street 1:1209 N SUMMERBROOK AVE STE 100
Practice Address - Street 2:
Practice Address - City:MERIDIAN
Practice Address - State:ID
Practice Address - Zip Code:83642-8750
Practice Address - Country:US
Practice Address - Phone:208-938-5823
Practice Address - Fax:208-938-5306
Is Sole Proprietor?:No
Enumeration Date:2006-01-10
Last Update Date:2022-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDM-15220207Y00000X
CAA92113207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology