Organization Active NPI

Harold T. Wilkerson DMD PSC

  • Dentist
  • Campbellsville, KY
National Provider Identifier
1013053883
Registry record updated Apr 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
HAROLD T. WILKERSON DMD PSC
Practice address
227 W Main St
Campbellsville, KY 42718-2325
Phone
(270) 465-6204
Fax
(270) 469-9424
NPI assigned
Jan 29, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Harold T. Wilkerson, DMDNPI 1053474338
Title
President
Phone
(270) 465-6204

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

227 W Main St
Campbellsville, KY 42718-2325

Mailing address

227 W Main St
Campbellsville, KY 42718-2325
Phone (270) 465-6204

Other identifiers 1

IdentifierTypeStateIssuer
61943783MedicaidKY

National Provider Directory

National Provider Directory

Locations

227 W Main St
Campbellsville, KY 42718
Phone (270) 465-6204

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1013053883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "227 W MAIN ST",
            "city": "CAMPBELLSVILLE",
            "state": "KY",
            "postal_code": "427182325",
            "telephone_number": "270-465-6204",
            "fax_number": "270-469-9424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "227 W MAIN ST",
            "city": "CAMPBELLSVILLE",
            "state": "KY",
            "postal_code": "427182325",
            "telephone_number": "270-465-6204",
            "fax_number": "270-469-9424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAROLD T. WILKERSON DMD PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-29",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "WILKERSON",
        "authorized_official_first_name": "HAROLD",
        "authorized_official_middle_name": "T.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "270-465-6204",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "61943783",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Campbellsville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.