Individual
JASON EDWIN WILCOX
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PMHNP-BC
Contact information
Practice address
163 S TALLAHASSEE ST, HAZLEHURST, GA 31539-6465
(912) 699-6447
Mailing address
163 S TALLAHASSEE ST, HAZLEHURST, GA 31539-6465
(912) 699-6447
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
RN282877
GA
Other
Enumeration date
06/14/2023
Last updated
10/09/2025
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