Individual
CHAUNCEY A WILKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4101 WOOLWORTH AVE, OMAHA, NE 68105-1850
(402) 346-8800
(402) 943-5575
Mailing address
4101 WOOLWORTH AVE, OMAHA, NE 68105-1850
(402) 346-8800
(402) 943-5575
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
17482
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10025024000
MEDICAID RHC
NE
05
—
47042628508
—
NE
Enumeration date
02/10/2006
Last updated
09/12/2016
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