Basic Information
| Provider Information | |||||||||
| NPI: | 1093985434 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WILKINS | ||||||||
| FirstName: | RICHARD | ||||||||
| MiddleName: | HARRY | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1278 ROOSEVELT TRL | ||||||||
| Address2: | |||||||||
| City: | RAYMOND | ||||||||
| State: | ME | ||||||||
| PostalCode: | 040716604 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2076556181 | ||||||||
| FaxNumber: | 2076556188 | ||||||||
| Practice Location | |||||||||
| Address1: | 1278 ROOSEVELT TRL | ||||||||
| Address2: | |||||||||
| City: | RAYMOND | ||||||||
| State: | ME | ||||||||
| PostalCode: | 040716604 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2076556181 | ||||||||
| FaxNumber: | 2076556188 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/29/2008 | ||||||||
| LastUpdateDate: | 10/16/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QM1300X | DO2302 | ME | Y | Ambulatory Health Care Facilities | Clinic/Center | Multi-Specialty | 2083X0100X | DO2302 | ME | N | Allopathic & Osteopathic Physicians | Preventive Medicine | Occupational Medicine | 208D00000X | DO2302 | ME | N | Allopathic & Osteopathic Physicians | General Practice |
No ID Information.