Provider Demographics
NPI:1902929342
Name:WILKINSON, DONALD ARTHUR (MSW)
Entity Type:Individual
Prefix:MR
First Name:DONALD
Middle Name:ARTHUR
Last Name:WILKINSON
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:340 COURT ST
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02360-4334
Mailing Address - Country:US
Mailing Address - Phone:508-747-1074
Mailing Address - Fax:508-747-5728
Practice Address - Street 1:340 COURT ST
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02360-4334
Practice Address - Country:US
Practice Address - Phone:508-747-1074
Practice Address - Fax:508-747-5728
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1043951041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAPO4083Medicare UPIN