Individual
DR. MARK J WILKINSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
101 MED TECH PKWY, SUITE 305, JOHNSON CITY, TN 37604-4007
(423) 926-6266
(423) 926-7599
Mailing address
PO BOX 5576, JOHNSON CITY, TN 37602-5576
(423) 926-6266
(423) 926-7599
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
27138
TN
207Q00000X
Family Medicine Physician
Primary
MD27138
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1588619738
—
VA
05
—
3096514
—
TN
05
—
3096515
—
TN
05
—
64068216
—
KY
05
—
890544Q
—
NC
01
—
930067763
RR MEDICARE
—
Enumeration date
05/24/2006
Last updated
03/04/2011
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