Organization
FAMILY AND SPORTS MEDICINE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KIRK ALEXANDER WILCOX MD (MD/PRESIDENT)
(423) 870-2030
Entity
Organization
Contact information
Practice address
1025 EXECUTIVE DR, SUITE 100, HIXSON, TN 37343-7916
(423) 870-2030
(423) 875-6405
Mailing address
1025 EXECUTIVE DR, SUITE 100, HIXSON, TN 37343-7916
(423) 870-2030
(423) 875-6405
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3053865
—
TN
05
—
3082742
—
TN
05
—
3168293
—
TN
Enumeration date
08/31/2005
Last updated
03/22/2011
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