Individual
MRS. JOAN WILKINSON-WILDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AA
Contact information
Practice address
1968 PEACHTREE ROAD NW, ATLANTA, GA 30309-1281
(404) 351-1754
(404) 351-7121
Mailing address
PO BOX 551420, FORT LAUDERDALE, FL 33355-1420
(800) 243-3839
(954) 839-2569
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
003421
GA
367H00000X
Anesthesiologist Assistant
Primary
003421
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000137167T
—
GA
Enumeration date
07/19/2006
Last updated
10/04/2010
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