Provider Demographics
NPI:1962445056
Name:WILKERSON, WILLIAM CHRISTOPHER (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:CHRISTOPHER
Last Name:WILKERSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 81689
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36689-1689
Mailing Address - Country:US
Mailing Address - Phone:251-380-2054
Mailing Address - Fax:251-380-2056
Practice Address - Street 1:3475 SPRING HILL AVE
Practice Address - Street 2:SUITE C
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36608-1522
Practice Address - Country:US
Practice Address - Phone:251-380-2054
Practice Address - Fax:251-380-2056
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-14
Last Update Date:2015-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL111162084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009994360Medicaid
AL009994360Medicaid
ALC75933Medicare UPIN