Individual
JOHN ROBERT WILLCOCKSON
Active
Individual
JOHN ROBERT WILLCOCKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
0840
SD
207W00000X
Ophthalmology Physician
17563
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0001010
SD WELLMARK BLUE SHIELD I
SD
01
—
22051
NE BLUE SHIELD ID
NE
05
—
36-305015-14
—
NE
05
—
36-3050195-12
—
NE
05
—
36-3050195-18
—
NE
05
—
6300040
—
SD
01
—
840
DAKOTACARE PROVIDER ID
SD
Enumeration date
05/24/2005
Last updated
10/01/2019
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up