Individual
BRADFORD W WILKINSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6 MAIN ST, DURHAM, CT 06422
(860) 349-1058
(860) 358-8652
Mailing address
28 CRESCENT ST, MIDDLETOWN, CT 06457-3654
(860) 358-4820
(860) 358-6748
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
030907
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001309071
—
CT
Enumeration date
06/27/2006
Last updated
08/08/2012
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