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Individual
THAD W WILKEY
Active
Individual
THAD W WILKEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA280
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010138646
BLUE SHIELD
ID
01
—
000010139188
BLUE SHIELD
ID
01
—
000010147742
BLUE SHIELD
ID
05
—
806348800
—
ID
01
—
970026445
RAILROAD MEDICARE
ID
01
—
PACB4
BLUE CROSS
ID
01
—
PACC2
BLUE CROSS
ID
01
—
PANX1
BLUE CROSS
ID
Enumeration date
10/21/2005
Last updated
01/25/2021
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