Individual
DR. ALLISON RUSSANNE WILCOX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1108 S KALANCHOE AVE, BROKEN ARROW, OK 74012-0977
(404) 695-3685
Mailing address
1108 S KALANCHOE AVE, BROKEN ARROW, OK 74012-0977
(404) 695-3685
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
27558
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100739880A
—
OK
Enumeration date
02/23/2007
Last updated
11/01/2023
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