Provider Demographics
NPI:1548283518
Name:WILCOX, ERIC (DO)
Entity type:Individual
Prefix:DR
First Name:ERIC
Middle Name:
Last Name:WILCOX
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:181 LOMB MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14623-5608
Mailing Address - Country:US
Mailing Address - Phone:585-922-3100
Mailing Address - Fax:585-922-3109
Practice Address - Street 1:181 LOMB MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14623-5608
Practice Address - Country:US
Practice Address - Phone:585-922-3100
Practice Address - Fax:585-922-3109
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2021-04-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY243056207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYRB5062Medicare PIN