Wilcox, John Richardson
Wilcox, John Richardson is an individual health care provider with primary practice located at 4777 Us Highway 259 , Longview TX 75605-7668. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology, Allopathic & Osteopathic Physicians / Diagnostic Radiology. Allopathic & Osteopathic Physicians / Diagnostic Radiology is his primary health care specialty. Wilcox, John Richardson can be contacted via phone (903) 663-4800.Contact Information
Primary practice address
4777 Us Highway 259
Longview TX 75605-7668
Phone: (903) 663-4800
Fax: (903) 663-0378
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology | 2085R0204X | F0824 | Texas |
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | F0824 | Texas |
Profile Details
| NPI number | 1114920444 |
|---|---|
| LBN Legal business name | Wilcox, John Richardson |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 31st, 2005 |
| Last updated | Jun 22nd, 2012 - about 14 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 | 1114920444 | NPPES |
| Texas | Other | 8DB361 | BCBS TX |
| Texas | MEDICAID | 134263610 | BCBS TX |
| Texas | MEDICAID | 134263613 | BCBS TX |
| Texas | Other | P00995222 | BCBS TX |
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