Provider Demographics
NPI:1477182152
Name:PILKINTON, ALEX
Entity type:Individual
Prefix:
First Name:ALEX
Middle Name:
Last Name:PILKINTON
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:PO BOX 7527
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43017-0727
Mailing Address - Country:US
Mailing Address - Phone:740-592-5799
Mailing Address - Fax:740-594-8925
Practice Address - Street 1:75 HOSPITAL DR STE 340
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:OH
Practice Address - Zip Code:45701-2860
Practice Address - Country:US
Practice Address - Phone:740-592-5799
Practice Address - Fax:740-594-8925
Is Sole Proprietor?:No
Enumeration Date:2020-04-05
Last Update Date:2024-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36.004150213E00000X, 213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0069804Medicaid