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NPI Code Detail

MEDICARE: JOHN K. WOLCOTT MD

MEDICARE: JOHN K. WOLCOTT MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianH2190TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1396740064
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN K. WOLCOTT MD
Provider Business Mailing Address
First Line : 5174 FM 1252 W
Second Line :
City : KILGORE
State : TX
Zip : 75662-1961
Country : US
Telephone Number : 903-986-1901
Fax Number : 903-984-6151
Provider Business Practice Location Address
First Line : 5174 FM 1252 W
Second Line :
City : KILGORE
State : TX
Zip : 75662-1961
Country : US
Telephone Number : 903-986-1901
Fax Number : 903-984-6151
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/17/2005
Last Update Date : 11/09/2021

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Directions to “ JOHN K. WOLCOTT MD” Practice Location

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