Provider Demographics
NPI:1225188121
Name:WILKIN, TIMOTHEE TREVEVANT (DO, PA)
Entity Type:Individual
Prefix:DR
First Name:TIMOTHEE
Middle Name:TREVEVANT
Last Name:WILKIN
Suffix:
Gender:M
Credentials:DO, PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 497
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:AR
Mailing Address - Zip Code:72006-0497
Mailing Address - Country:US
Mailing Address - Phone:870-347-2534
Mailing Address - Fax:
Practice Address - Street 1:7300 DOLLARWAY RD
Practice Address - Street 2:
Practice Address - City:WHITE HALL
Practice Address - State:AR
Practice Address - Zip Code:71602-3094
Practice Address - Country:US
Practice Address - Phone:870-247-7088
Practice Address - Fax:870-247-7089
Is Sole Proprietor?:No
Enumeration Date:2007-01-11
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE1340207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5K460Medicare ID - Type Unspecified
ARG48434Medicare UPIN