Individual
DR. DALLAS CHARLES WILKINSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
200 S CHICAGO ST, HOT SPRINGS, SD 57747-2322
(605) 745-3175
Mailing address
200 S CHICAGO ST, HOT SPRINGS, SD 57747-2322
(605) 745-3175
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
575
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0007616
WELLMARK
SD
01
—
575
DAKOTACARE
SD
05
—
9200700
—
SD
Enumeration date
08/18/2006
Last updated
02/27/2020
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