Individual
MR. JACK EARL WILCOX
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NURSE PRACTITIONER
Contact information
Practice address
120 MEMORIAL DR, JACKSONVILLE, NC 28546-6328
(910) 353-0581
(910) 353-1536
Mailing address
120 MEMORIAL DR, JACKSONVILLE, NC 28546-6328
(910) 353-0581
(910) 353-1536
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
5005586
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7006283
—
NC
Enumeration date
06/14/2006
Last updated
07/08/2015
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