# DONALD L WIKOFF

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1336112473
- **Gender:** Man
- **Credential:** M.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208800000X | Urology Physician | 261QM2500X | TX | Yes |

## Other

- **Enumeration date:** 02/09/2006
- **Last updated:** 08/10/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 004362710 | AETNA | TX |
| 05 | — | 032599502 | — | TX |
| 01 | — | 100110440A | OKLAHOMA MEDICAID | OK |
| 01 | — | 8G2040 | BCBS INDIVIDUAL ID | TX |
| 01 | — | P00043687 | RR MEDICARE | TX |