Wilkerson, Brent Jerome
Wilkerson, Brent Jerome is an individual health care provider with primary practice located at 200 Patewood Dr Ste B400 , Greenville SC 29615-6306. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Otology & Neurotology, Student, Health Care / Student in an Organized Health Care Education/Training Program. Allopathic & Osteopathic Physicians / Otology & Neurotology is his primary health care specialty. Wilkerson, Brent Jerome can be contacted via phone (864) 454-4368.Contact Information
Primary practice address
200 Patewood Dr Ste B400
Greenville SC 29615-6306
Phone: (864) 454-4368
Fax: (864) 241-9232
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Otology & Neurotology | 207YX0901X | 4301108235 | Michigan |
| Student, Health Care / Student in an Organized Health Care Education/Training Program | 390200000X | ||
| Allopathic & Osteopathic Physicians / Otology & Neurotology | 207YX0901X | 86683 | South Carolina |
Profile Details
| NPI number | 1407167489 |
|---|---|
| LBN Legal business name | Wilkerson, Brent Jerome |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 24th, 2010 |
| Last updated | Dec 14th, 2022 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1407167489 | NPPES |
| South Carolina | MEDICAID | 866833 |
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