Wilcox, Jack Earl
Wilcox, Jack Earl is an individual health care provider with primary practice located at 120 Memorial Dr , Jacksonville NC 28546-6328. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, which is considered as his primary health care specialty. Wilcox, Jack Earl can be contacted via phone (910) 353-0581.Contact Information
Primary practice address
120 Memorial Dr
Jacksonville NC 28546-6328
Phone: (910) 353-0581
Fax: (910) 353-1536
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Pediatrics | 363LP0200X | 5005586 | North Carolina |
Profile Details
| NPI number | 1265475347 |
|---|---|
| LBN Legal business name | Wilcox, Jack Earl |
| Credentials | NURSE PRACTITIONER |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 14th, 2006 |
| Last updated | Jul 8th, 2015 - about 11 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 | 1265475347 | NPPES |
| North Carolina | MEDICAID | 7006283 |
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