TRACY LYNN WILKERSON DDS NPI 1528024460

NPI Information

Tracy Lynn Wilkerson, DDS is a pediatric dentistry dentist in Charleston, WV. The provider is an age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. Tracy Lynn Wilkerson, DDS NPI is 1528024460. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1400 KANAWHA BOULEVARD EAST
CHARLESTON, WV
ZIP 25301
Phone: (304) 345-0541
Fax: (304) 345-8718

The NPI 1528024460 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).

The enumeration date for this NPI number is 4/20/2006 and was last updated on 8/18/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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