BOBBY S WILKERSON (NPI# 1245212844) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245212844 |
| Entity Type | Individual |
| Full Name | BOBBY S WILKERSON |
| Credential | M.D. |
| Practice Address |
1227 N State St Suite 101 Jackson MS 39202-2002 |
| Practice Telephone | 6013552485 |
| Practice Fax Number | 6013531463 |
| Mailing Telephone | 6013552485 |
| Mailing Fax Number | 6013531463 |
| Enumeration Date | 2005-11-18 |
| Last Update Date | 2017-05-24 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
17599 | MS | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 04883219 | 05 | |
| MS | AETNA US HEALTHCARE | 7271728 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710593520 | Bobby Don Wilkerson | Physical Therapy Assistant | 2760 N Grandview Ave Ste A, Odessa, TX 79762-6953 | 2020-09-17 |
| Street Address |
1227 N STATE ST SUITE 101 |
| City | JACKSON |
| State | MS |
| Zip Code | 39202-2002 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740284389 | Van L Lackey | Internal Medicine | 1227 N State St, Ste 101, Jackson, MS 39202-2002 | 2005-06-10 |
| 1992958169 | Lori Beth Brent | Nurse Practitioner | 1227 N State St, Ste 101, Jackson, MS 39202-2002 | 2008-10-31 |
| 1295776136 | Jackson Oncology Associates | Internal Medicine | 1227 N State St, Ste 101, Jackson, MS 39202-2002 | 2006-06-10 |
| 1013911668 | Tammy H Young | Internal Medicine | 1227 N State St, Ste 101, Jackson, MS 39202-2002 | 2005-06-10 |
| 1912901513 | Grace G Shumaker | Internal Medicine | 1227 N State St, Ste 101, Jackson, MS 39202-2002 | 2005-06-10 |
| 1821092479 | Anne P Berthold | Nurse Practitioner | 1227 N State St, Ste 101, Jackson, MS 39202-2002 | 2005-06-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982234183 | Eva Mackenzie Carmody | Physician Assistant | 1190 N State St Suite 502, Jackson, MS 39202 | 2020-01-16 |
| 1750868691 | Katherine Walters | Nurse Practitioner | 501 Marshall St., Suite 400, Jackson, MS 39202 | 2018-07-24 |
| 1932638749 | Tylan Lee | Social Worker | 860 East River Place Suite 100, Jackson, MS 39202 | 2017-06-06 |
| 1417314725 | Euna Jyles | Counselor | 860 E River Pl, Jackson, MS 39202 | 2016-01-19 |
| 1255712048 | Edward Jonathan Breight | Specialist/Technologist | 1325 East Fortication Street, Jackson, MS 39202 | 2015-06-17 |
| 1881037703 | Kara Spinks Logan | Surgery | 1190 N State St Ste 502, Jackson, MS 39202 | 2013-04-10 |
| 1477876530 | Mick Inc. | Technician | 334 Josanna Street, Suite #209, Jackson, MS 39202 | 2010-03-03 |
| 1073724910 | Paul Frederic Dare | Anesthesiology | 1151 North State St., Suite 311, Jackson Anesthesia Associates, Jackson, MS 39202 | 2007-05-24 |
| 1225247703 | Lynn Kincannon Holland | Counselor | 911 Manship Street, Unit A, Jackson, MS 39202 | 2007-05-22 |
| 1457568149 | Incare Inc | Pulmonary Function Technologist | 1151 North State St, Suite 406, Jackson, MS 39202 | 2007-05-16 |
| Find all providers in zip 39202 | ||||
| Taxonomy Code | 207RH0003X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Hematology & Oncology |
| An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: definiton added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649469743 | Central Clinic, PC | Internal Medicine | 603 Lansing Ave, Jackson, MI 49202-3209 | 2007-10-15 |
| 1780713966 | Jackson Oncology Associates, Pllc | Internal Medicine | 1860 Chadwick Dr Ste 301, Jackson, MS 39204-3467 | 2007-03-05 |
| 1346379500 | Jackson Oncology Associates,pllc | Internal Medicine | 2969 Curran Dr N Ste 200, Jackson, MS 39216-4121 | 2007-03-05 |
| 1639119589 | Justin T Baker | Internal Medicine | 1227 N State St Ste 101, Jackson, MS 39202-2002 | 2006-06-08 |
| 1093779456 | Omar Ahmad | Internal Medicine | 36 Sandstone Cir, Suite A & B, Jackson, TN 38305-2098 | 2006-04-13 |
| 1235101437 | Gary G Shi | Internal Medicine | 617 New York Ranch Rd, Jackson, CA 95642-9328 | 2006-02-02 |
| 1144290032 | Brian N Walker | Internal Medicine | 322 Hospital Blvd, Jackson, TN 38305 | 2006-01-24 |
| 1740284389 | Van L Lackey | Internal Medicine | 1227 N State St, Ste 101, Jackson, MS 39202-2002 | 2005-06-10 |
| 1407393374 | W.a. Foote Memorial Hospital, Inc | Internal Medicine | 205 N. East Ave, Jackson, MI 49201 | 2017-01-30 |
| 1740607225 | West Clinic, P.C. | Internal Medicine | 322 Hospital Blvd, Jackson, TN 38305-2079 | 2014-03-24 |
| Find all providers in JACKSON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.