Provider Demographics
NPI:1407905847
Name:WILKINSON, DAVID (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:
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 1:12109 COUNTY ROAD 103
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:FL
Mailing Address - Zip Code:34484-2951
Mailing Address - Country:US
Mailing Address - Phone:352-205-8981
Mailing Address - Fax:
Practice Address - Street 1:1035 PIPER BLVD UNIT 1
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34110
Practice Address - Country:US
Practice Address - Phone:239-465-4157
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2021-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME97647208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP01214310OtherRAILROAD MCR
FLP01214310OtherRR MEDICARE
FL278296100Medicaid
FLP107230OtherFREEDOM HEALTH
FL1193519OtherWELLCARE
FLP01730266OtherCLEAR HEALTH ALLIANCE
FL4991807OtherCIGNA
FL07502OtherBCBS OF FL
FL7082839OtherAETNA
FLP107230OtherFREEDOM HEALTH
FL7082839OtherAETNA
FL4991807OtherCIGNA
FLP00413787Medicare PIN
FLP01730266OtherCLEAR HEALTH ALLIANCE