Provider Demographics
NPI:1598343899
Name:WILKERSON, KAYLIE BRADSHAW (MD)
Entity type:Individual
Prefix:DR
First Name:KAYLIE
Middle Name:BRADSHAW
Last Name:WILKERSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 SWEETBRIAR CIR
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MS
Mailing Address - Zip Code:39046-8055
Mailing Address - Country:US
Mailing Address - Phone:601-319-8970
Mailing Address - Fax:
Practice Address - Street 1:421 S 28TH AVE STE 200
Practice Address - Street 2:
Practice Address - City:HATTIESBURG
Practice Address - State:MS
Practice Address - Zip Code:39401-7208
Practice Address - Country:US
Practice Address - Phone:601-268-5640
Practice Address - Fax:601-261-3507
Is Sole Proprietor?:No
Enumeration Date:2021-03-30
Last Update Date:2025-08-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MS35330207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology