Provider Demographics
NPI:1508486051
Name:WILKERSON, RICHARD WESLEY JR (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:WESLEY
Last Name:WILKERSON
Suffix:JR
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 NEW AVE
Mailing Address - Street 2:
Mailing Address - City:BESSEMER
Mailing Address - State:AL
Mailing Address - Zip Code:35020-7340
Mailing Address - Country:US
Mailing Address - Phone:205-502-6155
Mailing Address - Fax:
Practice Address - Street 1:1815 9TH AVE N
Practice Address - Street 2:
Practice Address - City:BESSEMER
Practice Address - State:AL
Practice Address - Zip Code:35020-3421
Practice Address - Country:US
Practice Address - Phone:205-502-6155
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-24
Last Update Date:2020-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy