Provider Demographics
NPI:1427523471
Name:DR. DAVID WILCOXSON AND ASSOCIATES, LLC
Entity type:Organization
Organization Name:DR. DAVID WILCOXSON AND ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:C
Authorized Official - Last Name:WILCOXSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:480-867-7353
Mailing Address - Street 1:6641 E BAYWOOD AVE STE B3
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85206-1723
Mailing Address - Country:US
Mailing Address - Phone:480-867-7353
Mailing Address - Fax:480-867-7354
Practice Address - Street 1:6641 E BAYWOOD AVE STE B3
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85206-1723
Practice Address - Country:US
Practice Address - Phone:480-867-7353
Practice Address - Fax:480-867-7354
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-05
Last Update Date:2018-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty