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:
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Health care specialties

SpecialtyCodeLicense #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 12 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 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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