Provider Demographics
NPI:1225091937
Name:WILKINS, CHARLES EVERETT (MD)
Entity Type:Individual
Prefix:
First Name:CHARLES
Middle Name:EVERETT
Last Name:WILKINS
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 1:2233 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MONTROSE
Mailing Address - State:CO
Mailing Address - Zip Code:81401-3831
Mailing Address - Country:US
Mailing Address - Phone:970-249-3700
Mailing Address - Fax:970-497-8410
Practice Address - Street 1:630 E STAR CT
Practice Address - Street 2:
Practice Address - City:MONTROSE
Practice Address - State:CO
Practice Address - Zip Code:81401
Practice Address - Country:US
Practice Address - Phone:970-252-1020
Practice Address - Fax:970-252-1041
Is Sole Proprietor?:No
Enumeration Date:2006-04-11
Last Update Date:2023-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR.0049657207RC0000X
NM99142207RC0000X
TXF0828207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX136825010Medicaid
TX136825010Medicaid
NM347302406Medicare PIN