Individual
DONALD L WIKOFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2915 N MAIN ST, PARIS, TX 75460-9360
(903) 784-4044
(903) 784-4201
Mailing address
2915 N MAIN ST, PARIS, TX 75460-9360
(903) 784-4044
(903) 784-4201
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
261QM2500X
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
004362710
AETNA
TX
05
—
032599502
—
TX
01
—
100110440A
OKLAHOMA MEDICAID
OK
01
—
8G2040
BCBS INDIVIDUAL ID
TX
01
—
P00043687
RR MEDICARE
TX
Enumeration date
02/09/2006
Last updated
08/10/2014
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