Provider Demographics
NPI:1356784078
Name:WILKINSON, KORY (PHARMD)
Entity type:Individual
Prefix:DR
First Name:KORY
Middle Name:
Last Name:WILKINSON
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3800 LINCOLN WAY
Mailing Address - Street 2:
Mailing Address - City:AMES
Mailing Address - State:IA
Mailing Address - Zip Code:50014-3402
Mailing Address - Country:US
Mailing Address - Phone:515-292-8375
Mailing Address - Fax:515-292-1911
Practice Address - Street 1:3800 LINCOLN WAY
Practice Address - Street 2:
Practice Address - City:AMES
Practice Address - State:IA
Practice Address - Zip Code:50014-3402
Practice Address - Country:US
Practice Address - Phone:515-292-8375
Practice Address - Fax:515-292-1911
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-11
Last Update Date:2013-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA21104183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist