Individual
DR. DWAIN DAVIS WILKERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM.D
Contact information
Practice address
1650 COCHRANE CIR UNIT MEDDAC, FORT CARSON, CO 80913-4604
(719) 526-7000
Mailing address
7651 BUCKEYE TREE LN, COLORADO SPRINGS, CO 80927-4023
(719) 651-2090
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
0202207917
VA
183500000X
Pharmacist
Primary
PHA.0021939
CO
1835P2201X
Ambulatory Care Pharmacist
21939
CO
Other
Enumeration date
11/22/2009
Last updated
05/27/2022
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