Provider Demographics
NPI:1003598277
Name:WILCOX, JARED THOMAS (MD PHD FRCSC)
Entity Type:Individual
Prefix:DR
First Name:JARED
Middle Name:THOMAS
Last Name:WILCOX
Suffix:
Gender:M
Credentials:MD PHD FRCSC
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Mailing Address - Street 1:247 TAHOMA RD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40503-2051
Mailing Address - Country:US
Mailing Address - Phone:514-261-9443
Mailing Address - Fax:
Practice Address - Street 1:740 S LIMESTONE STE B101
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40536-0001
Practice Address - Country:US
Practice Address - Phone:859-323-5661
Practice Address - Fax:859-323-6411
Is Sole Proprietor?:No
Enumeration Date:2023-08-07
Last Update Date:2023-08-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KY57972207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery