Provider Demographics
NPI:1427192822
Name:WILKINS, M DAVIS (MD)
Entity Type:Individual
Prefix:
First Name:M DAVIS
Middle Name:
Last Name:WILKINS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MARGUERITE
Other - Middle Name:DAVIS
Other - Last Name:WILKINS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1208 BEALL LN
Mailing Address - Street 2:
Mailing Address - City:CENTRAL POINT
Mailing Address - State:OR
Mailing Address - Zip Code:97502-1573
Mailing Address - Country:US
Mailing Address - Phone:541-664-5151
Mailing Address - Fax:541-664-5155
Practice Address - Street 1:979 WINDEMAR DR
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:OR
Practice Address - Zip Code:97520-9747
Practice Address - Country:US
Practice Address - Phone:541-646-8575
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-18
Last Update Date:2009-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD27812207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine