Organization
WILKENS MEDICAL GROUP INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBRA J SHARP (ADMINISTRATION)
(423) 784-3667
Entity
Organization
Contact information
Practice address
131 HOSPITAL LN, JELLICO, TN 37762-4404
(423) 784-7269
(423) 784-3708
Mailing address
PO BOX 28, JELLICO, TN 37762-0028
(423) 784-7269
(423) 784-3708
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3717798
—
TN
05
—
65938771
—
KY
Enumeration date
01/17/2007
Last updated
11/20/2019
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