Healthcare Provider Details

I. General information

NPI: 1902860026
Provider Name (Legal Business Name): S L WILCOX HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/14/2006
Last Update Date: 09/12/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3428 BRODHEAD RD
MONACA PA
15061-3132
US

IV. Provider business mailing address

3428 BRODHEAD RD
MONACA PA
15061-3132
US

V. Phone/Fax

Practice location:
  • Phone: 724-774-7756
  • Fax: 724-774-7874
Mailing address:
  • Phone: 724-774-7756
  • Fax: 724-774-7874

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. SIMMON L. WILCOX
Title or Position: PRESIDENT
Credential: M.D.
Phone: 724-774-7756