Individual
DENNIS EMERY WILCOXON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
2643 GULF TO BAY BLVD STE 1520, CLEARWATER, FL 33759
(727) 799-3937
(727) 210-1189
Mailing address
1950 OLD GALLOWS RD STE 520, VIENNA, VA 22182-3970
(703) 847-8899
(571) 223-6780
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC 2255
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
078875900
—
FL
01
—
410039521
RAIL ROAD MEDICARE
FL
Enumeration date
06/22/2005
Last updated
05/31/2019
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