Provider Demographics
NPI:1245273754
Name:WILKINSON, DAVID CARROLL II (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:CARROLL
Last Name:WILKINSON
Suffix:II
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:2122 HWY 71 S STE 101
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:TX
Mailing Address - Zip Code:78934-3011
Mailing Address - Country:US
Mailing Address - Phone:979-732-2318
Mailing Address - Fax:979-732-2310
Practice Address - Street 1:2122 HWY 71 S STE 101
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:TX
Practice Address - Zip Code:78934-3011
Practice Address - Country:US
Practice Address - Phone:979-732-2318
Practice Address - Fax:979-732-2310
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-13
Last Update Date:2022-07-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXE6686207P00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXC23497Medicare UPIN