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:
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Health care specialties

SpecialtyCodeLicense #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 2 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1407167489 NPPES
South Carolina MEDICAID 866833

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