Individual
ALTON JEROME WILKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
212 W WINTERGREEN RD APT 2028, DESOTO, TX 75115-2360
(214) 457-5528
Mailing address
212 W WINTERGREEN RD APT 2028, DESOTO, TX 75115-2360
(214) 457-5528
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
2164
TX
213EP1101X
Primary Podiatric Medicine Podiatrist
2164
TX
213ES0103X
Foot & Ankle Surgery Podiatrist
2164
TX
Other
Enumeration date
04/05/2010
Last updated
03/30/2016
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