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Individual

DR. FRED CLAYTON WILKINS JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
104 ANTHEM AVE, HERNDON, VA 20170-5161
(703) 376-7296
Mailing address
104 ANTHEM AVE, HERNDON, VA 20170-5161
(703) 376-7296

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
22248
AL
208D00000X
General Practice Physician
Primary
22248
AL

Other

Enumeration date
12/19/2013
Last updated
12/19/2013
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