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NPI Code Detail

MEDICARE: DENNIS EMERY WILCOXON O.D.

MEDICARE:   DENNIS EMERY WILCOXON  O.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
1152W00000XOptometristOPC 2255FL

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1410039521OTHERFLRAIL ROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1932105178
Entity Type Code : Individual
Provider Name (Legal Business Name) : DENNIS EMERY WILCOXON O.D.
Provider Business Mailing Address
First Line : 1950 OLD GALLOWS RD STE 520
Second Line :
City : VIENNA
State : VA
Zip : 22182-3970
Country : US
Telephone Number : 703-847-8899
Fax Number : 571-223-6780
Provider Business Practice Location Address
First Line : 2643 GULF TO BAY BLVD STE 1520
Second Line :
City : CLEARWATER
State : FL
Zip : 33759
Country : US
Telephone Number : 727-799-3937
Fax Number : 727-210-1189
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/22/2005
Last Update Date : 05/31/2019

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Directions to “ DENNIS EMERY WILCOXON O.D.” Practice Location

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