Provider Demographics
NPI:1669403028
Name:WILKEN, ERIKA C (OD)
Entity type:Individual
Prefix:
First Name:ERIKA
Middle Name:C
Last Name:WILKEN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7239 S BONARDEN LN
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85283-4726
Mailing Address - Country:US
Mailing Address - Phone:602-663-0580
Mailing Address - Fax:
Practice Address - Street 1:2425 E CAMELBACK RD
Practice Address - Street 2:SUITE 106
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85016-4200
Practice Address - Country:US
Practice Address - Phone:602-224-5772
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2007-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1480152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist