Provider Demographics
NPI:1730123746
Name:WILKEY, NEIL L (MD)
Entity Type:Individual
Prefix:DR
First Name:NEIL
Middle Name:L
Last Name:WILKEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2920 DIVISION ST
Mailing Address - Street 2:
Mailing Address - City:SAINT JOSEPH
Mailing Address - State:MI
Mailing Address - Zip Code:49085-2437
Mailing Address - Country:US
Mailing Address - Phone:269-982-7844
Mailing Address - Fax:269-982-1783
Practice Address - Street 1:2920 DIVISION ST
Practice Address - Street 2:
Practice Address - City:SAINT JOSEPH
Practice Address - State:MI
Practice Address - Zip Code:49085-2437
Practice Address - Country:US
Practice Address - Phone:269-982-7844
Practice Address - Fax:269-982-1783
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI43010813132084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
G87340Medicare UPIN
ON26020Medicare ID - Type Unspecified