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Individual

DR. GREGORY CHARLES WILKENS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
515 MEMORIAL DR STE 1, MANCHESTER, KY 40962-9157
(606) 598-4534
(606) 599-2524
Mailing address
509 MEMORIAL DR STE 2, MANCHESTER, KY 40962-6196
(606) 598-5104
(606) 598-0983

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
38097
KY
208600000X
Surgery Physician
MD0000035379
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3885392
TN
05
64064413
KY
Enumeration date
10/03/2006
Last updated
01/16/2020
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