# C H WILKINSON PHYSICIAN NETWORK

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- **Entity:** Organization
- **Status:** Active
- **Other names:** CHRISTUS Medical Group
- **Organization subpart:** No

## Provider details

- **NPI number:** 1295987709
- **Authorized official:** DONNA J MIKULECKY (CEO PRESIDENT)
- **Authorized official phone:** (713) 277-2208

## Contact information

- **Practice address:** 1736 W. PRIEN LAKE ROAD, LAKE CHARLES, LA 70601
- **Practice address phone:** (337) 478-5085
- **Practice address fax:** (337) 478-5086
- **Mailing address:** 1736 W. PRIEN LAKE ROAD, LAKE CHARLES, LA 70601
- **Mailing address phone:** (337) 478-5085
- **Mailing address fax:** (337) 478-5086

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 10/15/2008
- **Last updated:** 10/15/2008