Healthcare Provider Details

I. General information

NPI: 1538363312
Provider Name (Legal Business Name): DENNIS D. WILCOX, M.D., INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/13/2007
Last Update Date: 11/10/2020
Certification Date: 11/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3800 JANES RD
ARCATA CA
95521-4742
US

IV. Provider business mailing address

3800 JANES RD
ARCATA CA
95521-4742
US

V. Phone/Fax

Practice location:
  • Phone: 530-241-1473
  • Fax: 707-825-4988
Mailing address:
  • Phone: 707-822-2279
  • Fax: 707-825-4988

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberA44471
License Number StateCA

VIII. Authorized Official

Name: MS. BARBARA R. WILCOX
Title or Position: OFFICE MANAGER
Credential:
Phone: 707-822-2279