Provider Demographics
NPI:1407242324
Name:WILKINSON, BRETT ALAN (MD)
Entity Type:Individual
Prefix:DR
First Name:BRETT
Middle Name:ALAN
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 1:2900 INDIANA AVE
Mailing Address - Street 2:
Mailing Address - City:KENNER
Mailing Address - State:LA
Mailing Address - Zip Code:70065-4605
Mailing Address - Country:US
Mailing Address - Phone:504-575-3712
Mailing Address - Fax:504-575-3691
Practice Address - Street 1:8050 W JUDGE PEREZ DR STE 1300
Practice Address - Street 2:
Practice Address - City:CHALMETTE
Practice Address - State:LA
Practice Address - Zip Code:70043
Practice Address - Country:US
Practice Address - Phone:504-575-3712
Practice Address - Fax:504-575-3691
Is Sole Proprietor?:No
Enumeration Date:2015-04-07
Last Update Date:2021-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA308225207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine