Wilkinson, Mark J

Wilkinson, Mark J is an individual health care provider with primary practice located at 101 Med Tech Pkwy Suite 305, Johnson City TN 37604-4007. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Emergency Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Wilkinson, Mark J can be contacted via phone (423) 926-6266.

Contact Information

Primary practice address
101 Med Tech Pkwy Suite 305 Johnson City TN 37604-4007
Phone: (423) 926-6266
Fax: (423) 926-7599
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X MD27138 Tennessee
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 27138 Tennessee

Profile Details

NPI number 1588619738
LBN Legal business name Wilkinson, Mark J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 24th, 2006
Last updated Mar 4th, 2011 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1588619738 NPPES
Tennessee MEDICAID 3096514
Tennessee MEDICAID 1588619738
Tennessee MEDICAID 890544Q
Tennessee MEDICAID 64068216
Tennessee MEDICAID 3096515
Tennessee Other 930067763

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