Individual
BRENT JEROME WILKERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
200 PATEWOOD DR STE B400, GREENVILLE, SC 29615-6306
(864) 454-4368
(864) 241-9232
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 522-8603
Taxonomy
Speciality
Code
Description
License number
State
207YX0901X
Otology & Neurotology Physician
4301108235
MI
207YX0901X
Otology & Neurotology Physician
Primary
86683
SC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
866833
—
SC
Enumeration date
06/24/2010
Last updated
12/14/2022
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