Individual
GLENN LOCKHART WILCOX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DOM
Contact information
Practice address
5353 WYOMING BLVD NE, SUITE 4, ALBUQUERQUE, NM 87109-3132
(505) 771-4998
Mailing address
5353 WYOMING BLVD NE, SUITE 4, ALBUQUERQUE, NM 87109-3132
(505) 771-4998
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
34RX2
NM
Other
Enumeration date
12/18/2006
Last updated
02/25/2014
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