Individual
JAMES LEE WILKINSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
205 PAGE RD, PINEHURST, NC 28374-8798
(910) 295-5511
(910) 295-5481
Mailing address
205 PAGE RD, PINEHURST, NC 28374-8798
(910) 295-5511
(910) 295-5481
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
103312
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0372PA
SC MEDICAID PROVIDER#
SC
01
—
D3716
MEDCOST PROVIDER#
NC
01
—
FH4000415
FIRSTCAROLINACARE PROV.#
NC
01
—
P00156374
PALMETTO GBA PROVIDER#
NC
Enumeration date
07/05/2006
Last updated
07/08/2007
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