Individual
ROGER JAMES WOLCOTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5902 66TH ST, LUBBOCK, TX 79424-3048
(806) 797-2139
(806) 797-3105
Mailing address
5902 66TH ST UNIT B, LUBBOCK, TX 79424-5933
(806) 797-2139
(806) 797-3105
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
J4620
TX
208100000X
Physical Medicine & Rehabilitation Physician
J4620
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110687404
—
TX
05
—
172052601
—
TX
05
—
172053401
—
TX
Enumeration date
06/23/2005
Last updated
02/14/2023
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