Provider Demographics
NPI:1356434856
Name:WILKENS, TODD HENRY (MD)
Entity type:Individual
Prefix:DR
First Name:TODD
Middle Name:HENRY
Last Name:WILKENS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:410 42ND AVE N STE 400
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37209-3658
Mailing Address - Country:US
Mailing Address - Phone:615-292-5722
Mailing Address - Fax:615-346-6225
Practice Address - Street 1:515 STONECREST PKWY STE 230
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:TN
Practice Address - Zip Code:37167-6829
Practice Address - Country:US
Practice Address - Phone:615-223-9935
Practice Address - Fax:615-891-5046
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2023-09-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TNMD0000026875208600000X, 2086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64064397Medicaid
TN3885402Medicaid
KY64064397Medicaid
TN3885402Medicare ID - Type Unspecified
TN3885402Medicaid