Individual
DAVID C WILKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1400 S LAKE PARK AVE, SUITE 105, HOBART, IN 46342-6790
(219) 942-5599
(219) 942-5544
Mailing address
9660 WICKER AVE, ST JOHN, IN 46373-9487
(219) 226-2203
(219) 226-2202
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
01031776A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100406800
—
IN
01
—
256700C
MEDICARE PTAN
IN
Enumeration date
07/29/2005
Last updated
11/29/2012
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