Individual
DR. JACQUELINE CAROL WILK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2825 E BARNETT RD, MEDFORD, OR 97504-8332
(541) 789-4700
Mailing address
1208 BEALL LN, CENTRAL POINT, OR 97502-1573
(541) 664-5151
(541) 664-5155
Taxonomy
Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
MD29023
OR
2080P0203X
Pediatric Critical Care Medicine Physician
MD29023
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MD29023
MEDICAL LICENSE
OR
Enumeration date
08/21/2007
Last updated
06/10/2009
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