Provider Demographics
NPI:1316015050
Name:WILKIE, DAVID JAMES (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:JAMES
Last Name:WILKIE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:300 W HOSPITAL RD
Mailing Address - Street 2:INTERDISCIPLINARY PAIN MANAGEMENT CENTER
Mailing Address - City:FORT GORDON
Mailing Address - State:GA
Mailing Address - Zip Code:30905-5741
Mailing Address - Country:US
Mailing Address - Phone:706-787-8322
Mailing Address - Fax:706-787-0196
Practice Address - Street 1:300 W HOSPITAL RD
Practice Address - Street 2:INTERDISCIPLINARY PAIN MANAGEMENT CENTER
Practice Address - City:FORT GORDON
Practice Address - State:GA
Practice Address - Zip Code:30905-5741
Practice Address - Country:US
Practice Address - Phone:706-787-8322
Practice Address - Fax:706-787-0196
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2015-07-24
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Provider Licenses
StateLicense IDTaxonomies
MI43010645972084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAD000Medicare UPIN