Provider Demographics
NPI:1942288469
Name:WILKES, ROBYN H (AUD)
Entity Type:Individual
Prefix:DR
First Name:ROBYN
Middle Name:H
Last Name:WILKES
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 GROVE PARK LN STE 800
Mailing Address - Street 2:
Mailing Address - City:DOTHAN
Mailing Address - State:AL
Mailing Address - Zip Code:36305-5912
Mailing Address - Country:US
Mailing Address - Phone:334-702-4327
Mailing Address - Fax:334-702-4328
Practice Address - Street 1:200 GROVE PARK LN STE 800
Practice Address - Street 2:
Practice Address - City:DOTHAN
Practice Address - State:AL
Practice Address - Zip Code:36305-5912
Practice Address - Country:US
Practice Address - Phone:334-702-4327
Practice Address - Fax:334-702-4328
Is Sole Proprietor?:No
Enumeration Date:2006-01-04
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL923A231H00000X, 237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
No231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009925185Medicaid
AL1942288469Medicare UPIN