Provider Demographics
NPI:1811030729
Name:WILKES, JAMES C (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:C
Last Name:WILKES
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Gender:M
Credentials:MD
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Mailing Address - Street 1:3320 TATES CREEK RD
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40502-3400
Mailing Address - Country:US
Mailing Address - Phone:859-269-4604
Mailing Address - Fax:859-266-0062
Practice Address - Street 1:3320 TATES CREEK RD
Practice Address - Street 2:3RD FLOOR
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40502-3400
Practice Address - Country:US
Practice Address - Phone:859-269-4604
Practice Address - Fax:859-266-0062
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-14
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
KY18582208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64079098Medicaid