MEDICARE: CLIFTON WILCOX M.D.

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
1	208D00000X	General Practice Physician	0101248669	VA

General Provider Information

NPI Number	:	1679863419
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CLIFTON WILCOX M.D.

Provider Business Mailing Address
First Line	:	7700 ARLINGTON BLVD STE 5113
Second Line	:
City	:	FALLS CHURCH
State	:	VA
Zip	:	22042-5190
Country	:	US
Telephone Number	:	703-681-9126
Fax Number	:

Provider Business Practice Location Address
First Line	:	7700 ARLINGTON BLVD STE 5113
Second Line	:
City	:	FALLS CHURCH
State	:	VA
Zip	:	22042-5190
Country	:	US
Telephone Number	:	703-681-9126
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/13/2011
Last Update Date	:	04/29/2025

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