Individual
DR. PETER EDWARD WILCOX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0618000147
VA
152WC0802X
Corneal and Contact Management Optometrist
0618000147
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1250960001
MEDICARE DMERC
—
05
—
92-3438-1
—
VA
Enumeration date
05/23/2005
Last updated
08/20/2012
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