Organization
CHILDREN'S PSYCHIATRIC CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN E WILKAITIS M.D. (OWNER)
(601) 829-4170
Entity
Organization
Contact information
Practice address
3531 LAKELAND DR STE 1052, FLOWOOD, MS 39232-8016
(601) 829-4170
Mailing address
3531 LAKELAND DR STE 1052, FLOWOOD, MS 39232-8016
(601) 982-8531
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03932074
—
MS
Enumeration date
07/08/2013
Last updated
07/23/2024
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