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NPI Code Detail

MEDICARE: MELANIE DECOCK WILSON P.A.

MEDICARE: MELANIE DECOCK WILSON P.A.
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
1363A00000XPhysician Assistant002436IA

General Provider Information

NPI Number : 1467556787
Entity Type Code : Individual
Provider Name (Legal Business Name) : MELANIE DECOCK WILSON P.A.
Provider Business Mailing Address
First Line : 2900 S 25TH ST STE B2
Second Line :
City : CLINTON
State : IA
Zip : 52732-7250
Country : US
Telephone Number : 563-519-8120
Fax Number :
Provider Business Practice Location Address
First Line : 2900 S 25TH ST STE B2
Second Line :
City : CLINTON
State : IA
Zip : 52732-7250
Country : US
Telephone Number : 563-519-8120
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/08/2006
Last Update Date : 03/05/2026

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Directions to “ MELANIE DECOCK WILSON P.A.” Practice Location

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