Provider Demographics
NPI:1922072511
Name:WILKINS, DONNA ALFORD (MD)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:ALFORD
Last Name:WILKINS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:DONNA
Other - Middle Name:A
Other - Last Name:WILKINS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:125 N MULBERRY ST
Mailing Address - Street 2:
Mailing Address - City:MUNCIE
Mailing Address - State:IN
Mailing Address - Zip Code:47305-1718
Mailing Address - Country:US
Mailing Address - Phone:765-587-0670
Mailing Address - Fax:765-747-7747
Practice Address - Street 1:DELAWARE COUNTY HEALTH DEPARTMENT
Practice Address - Street 2:125 NORTH MULBERRY STREET
Practice Address - City:MUNCIE
Practice Address - State:IN
Practice Address - Zip Code:47305-1718
Practice Address - Country:US
Practice Address - Phone:765-587-0670
Practice Address - Fax:765-747-7747
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-13
Last Update Date:2020-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01026405208000000X, 2080N0001X, 251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000304598OtherANTHEM BC/BS
IN300039005Medicaid
IN208790CMedicare PIN
IND69464Medicare UPIN