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Individual
G JASON WILKS
Active
Individual
G JASON WILKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
DP00318
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
067946000
REGENCE
OR
01
—
430895102
REGENCE BC HMO
OR
01
—
480028890
RR MEDICARE
—
05
—
500720262
—
OR
01
—
7600580001
PTAN DME
OR
01
—
D201111
PACIFIC SOURCE
OR
01
—
DX4938
RR MDC GROUP PTAN
OR
01
—
R192914
PTAN MEDICARE ORGANIZATION
OR
Enumeration date
12/06/2006
Last updated
11/12/2025
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