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Individual

EDMUND L WILKINS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1724 ROCKINGHAM AVE, STE 201, BOWLING GREEN, KY 42104-5841
(270) 745-0040
(270) 745-0041
Mailing address
1724 ROCKINGHAM AVE, STE 201, BOWLING GREEN, KY 42104-5841
(270) 745-0040
(270) 745-0041

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
18148
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000049570
ANTHEM PIN NUMBER
KY
01
000000059919
ANTHEM PROVIDER ID NUMBER
KY
05
64181480
KY
Enumeration date
06/20/2005
Last updated
07/08/2007
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