Individual
DR. WILLIAM KURT WILKENING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O. D.
Contact information
Practice address
935 ROYAL AVE, MEDFORD, OR 97504-6140
(541) 779-2211
(541) 779-8778
Mailing address
935 ROYAL AVE, MEDFORD, OR 97504-6140
(541) 779-2211
(541) 779-8778
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1569ATI
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
229948
—
OR
Enumeration date
05/28/2006
Last updated
06/30/2016
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