Individual
JASON WAYNE WILKERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
506 WILLOW STREET, SPRINGFIELD, TN 37172
(615) 384-8435
(615) 384-0855
Mailing address
506 WILLOW STREET, SPRINGFIELD, TN 37172
(615) 384-8435
(615) 384-0855
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OD0000002007
TN
152W00000X
Optometrist
TN2007
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3943216
—
TN
Enumeration date
11/09/2006
Last updated
03/05/2010
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