Provider Demographics
NPI:1790382711
Name:WILKINS, MARY-KATHRYN CHRISTINE (PA)
Entity Type:Individual
Prefix:
First Name:MARY-KATHRYN
Middle Name:CHRISTINE
Last Name:WILKINS
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:820 ST. SEBASTIAN WAY
Mailing Address - Street 2:SUITE 1A
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30901-2635
Mailing Address - Country:US
Mailing Address - Phone:706-651-8400
Mailing Address - Fax:706-651-8868
Practice Address - Street 1:820 ST. SEBASTIAN WAY
Practice Address - Street 2:SUITE 1A
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30901-2635
Practice Address - Country:US
Practice Address - Phone:706-651-8400
Practice Address - Fax:706-651-8868
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-02
Last Update Date:2022-03-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA10038363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant