Provider Demographics
NPI:1225028756
Name:WILKINS, JOHN W III (DC)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:W
Last Name:WILKINS
Suffix:III
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:226 EAST STATE STREET
Mailing Address - Street 2:
Mailing Address - City:KENNETT SQUARE
Mailing Address - State:PA
Mailing Address - Zip Code:19348-3125
Mailing Address - Country:US
Mailing Address - Phone:610-444-8155
Mailing Address - Fax:610-444-8199
Practice Address - Street 1:226 EAST STATE STREET
Practice Address - Street 2:
Practice Address - City:KENNETT SQUARE
Practice Address - State:PA
Practice Address - Zip Code:19348-3125
Practice Address - Country:US
Practice Address - Phone:610-444-8155
Practice Address - Fax:610-444-8199
Is Sole Proprietor?:No
Enumeration Date:2005-10-26
Last Update Date:2021-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC006888L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA093672Medicare ID - Type Unspecified
PAU90940Medicare UPIN