Provider Demographics
NPI:1538433115
Name:HUGH WILKINSON,MD PA
Entity type:Organization
Organization Name:HUGH WILKINSON,MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HUGH
Authorized Official - Middle Name:A
Authorized Official - Last Name:WILKINSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-740-7970
Mailing Address - Street 1:10416 SAINT GERMAIN CT
Mailing Address - Street 2:
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33449-8058
Mailing Address - Country:US
Mailing Address - Phone:561-516-0512
Mailing Address - Fax:
Practice Address - Street 1:2828 S SEACREST BLVD
Practice Address - Street 2:SUITE 208
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33435-7944
Practice Address - Country:US
Practice Address - Phone:561-740-7970
Practice Address - Fax:561-740-7980
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-29
Last Update Date:2012-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME94184261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLFL 273894500Medicaid