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General NPI Number Information
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NPI Number | 1578079950
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Entity Type | Individual
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Provider Name | CATHERINE FALGOUT WILCOX PA-C
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Gender | Female
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Dates
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Enumeration Date | 12/20/2017
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Last Update Date | 05/18/2024
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Provider Practice Location Address
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Address Line | 1101 HONOR HEIGHTS DR
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City | MUSKOGEE
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State | OK
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Zip | 74401-1302
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Country | US
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Telephone | 918-577-3000
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Fax |
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Provider Business Mailing Address
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Address Line | 22161 S WILDWOOD PL
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City | CLAREMORE
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State | OK
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Zip | 74019-1821
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Country | US
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Telephone | 985-855-4436
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 2875
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License Number State | OK
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