Provider Demographics
NPI:1609939206
Name:WILKINS, STEVEN ROWLAND (OD)
Entity Type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:ROWLAND
Last Name:WILKINS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5386 KEMPSRIVER DR
Mailing Address - Street 2:SUITE 101
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23464-5349
Mailing Address - Country:US
Mailing Address - Phone:757-420-2001
Mailing Address - Fax:757-420-3693
Practice Address - Street 1:5386 KEMPSRIVER DR
Practice Address - Street 2:SUITE 101
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23464-5349
Practice Address - Country:US
Practice Address - Phone:757-420-2001
Practice Address - Fax:757-420-3693
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-18
Last Update Date:2013-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618000419152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAVV82430281OtherMEDICARE PTAN
VAP01143095OtherRAILROAD MEDICARE PTAN
VAVV82430281Medicare PIN
VAP01143095OtherRAILROAD MEDICARE PTAN
VAP01143095Medicare PIN