Individual
LEONARD WILKINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
209 WOODLAWN AVE, TAHLEQUAH, OK 74464-3317
(918) 456-0585
(918) 456-6232
Mailing address
209 WOODLAWN AVE, TAHLEQUAH, OK 74464-3317
(918) 456-0585
(918) 456-6232
Taxonomy
Speciality
Code
Description
License number
State
152WC0802X
Corneal and Contact Management Optometrist
Primary
815
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0676100001
DMERC/PIN
—
05
—
100767470A
—
OK
01
—
156833
FED NWO
—
01
—
5001
NEFN DISP
—
01
—
900243
OK. NWO
OK
Enumeration date
09/06/2006
Last updated
11/14/2011
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