Provider Demographics
NPI:1508627423
Name:WILCOX, COLIN RICHARD
Entity Type:Individual
Prefix:MR
First Name:COLIN
Middle Name:RICHARD
Last Name:WILCOX
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 MURRAY HILL DR
Mailing Address - Street 2:
Mailing Address - City:MOUNT MORRIS
Mailing Address - State:NY
Mailing Address - Zip Code:14510-1691
Mailing Address - Country:US
Mailing Address - Phone:585-243-7299
Mailing Address - Fax:585-243-6794
Practice Address - Street 1:2 MURRAY HILL DR
Practice Address - Street 2:
Practice Address - City:MOUNT MORRIS
Practice Address - State:NY
Practice Address - Zip Code:14510-1691
Practice Address - Country:US
Practice Address - Phone:585-243-7299
Practice Address - Fax:585-243-6794
Is Sole Proprietor?:No
Enumeration Date:2024-01-18
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator