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Contact Information

G J WILKS, DPM
1813 W HARVARD AVE STE 201
ROSEBURG, OR97471
 Phone: 541-673-0742
 Fax: 541-673-7553
 Website: https://www.wilksadvancedfootcare.com/
 

Specialty

Taxonomy Code Specialty Code Provider Type

Podiatrist

213E00000X 48 Podiatry
Indicates primary specialty

NPI Profile & details for G J WILKS · (Male)

NPI Number 1316006539
Status Active
Credentials DPM (Doctor of Podiatric Medicine)
Entity Individual
Enumeration date 12/06/2006
Last updated 11/12/2025 - About 7 months ago
Sole proprietor 1 Yes
Identifiers
  • OR License # DP00318
  • OR Medicaid 500720262
  • Other 480028890 RR MEDICARE
  • OR Other D201111 PACIFIC SOURCE
  • OR Other 7600580001 PTAN DME
  • OR Other R192914 PTAN MEDICARE ORGANIZATION
  • OR Other 067946000 REGENCE
  • OR Other 430895102 REGENCE BC HMO
  • OR Other DX4938 RR MDC GROUP PTAN
Hospital affiliation(s)
  • MERCY MEDICAL CENTER - (Acute Care)
    2700 NW STEWART PARKWAY
    ROSEBURG, OR 97471
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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