Individual
DR. BYRON N WILKES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3805 WEST 28TH, PINE BLUFF, AR 71603
(870) 536-4100
(870) 536-9020
Mailing address
3805 WEST 28TH, PINE BLUFF, AR 71603
(870) 536-4100
(870) 536-9020
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
44011
KY
207W00000X
Ophthalmology Physician
44011
KY
207W00000X
Ophthalmology Physician
48307
TN
207W00000X
Ophthalmology Physician
Primary
E7828
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000704725
ANTHEM - NICC
KY
01
—
124105
SIHO - NICC
KY
05
—
1529033
—
TN
05
—
193042001
—
AR
05
—
201012220
—
IN
05
—
7100137070
—
KY
Enumeration date
04/12/2007
Last updated
11/12/2020
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