Provider Demographics
NPI:1134606759
Name:WILKES, JOEL A
Entity type:Individual
Prefix:MR
First Name:JOEL
Middle Name:A
Last Name:WILKES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 ENGLISH ST
Mailing Address - Street 2:
Mailing Address - City:DOUGLAS
Mailing Address - State:GA
Mailing Address - Zip Code:31535-7036
Mailing Address - Country:US
Mailing Address - Phone:912-850-6918
Mailing Address - Fax:912-287-6689
Practice Address - Street 1:300 ENGLISH ST
Practice Address - Street 2:
Practice Address - City:DOUGLAS
Practice Address - State:GA
Practice Address - Zip Code:31535-7036
Practice Address - Country:US
Practice Address - Phone:912-850-6918
Practice Address - Fax:912-287-6689
Is Sole Proprietor?:No
Enumeration Date:2018-07-26
Last Update Date:2018-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator