Individual
CORY CHARLES WILCOX
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
555 N ARLINGTON AVE, RENO, NV 89503-4723
(775) 786-3040
(775) 788-5235
Mailing address
555 N ARLINGTON AVE, RENO, NV 89503-4723
(775) 786-3040
(775) 786-1887
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14948847
CAQH
—
05
—
1770143356
—
NV
Enumeration date
06/17/2019
Last updated
04/29/2022
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