Provider Demographics
NPI:1780678003
Name:WILCOX, LLOYD M (MD)
Entity Type:Individual
Prefix:
First Name:LLOYD
Middle Name:M
Last Name:WILCOX
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 PILLSBURY ST STE 100
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301-3502
Mailing Address - Country:US
Mailing Address - Phone:603-228-1104
Mailing Address - Fax:603-228-7061
Practice Address - Street 1:2 PILLSBURY ST STE 100
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-3502
Practice Address - Country:US
Practice Address - Phone:603-228-1104
Practice Address - Fax:603-228-7061
Is Sole Proprietor?:No
Enumeration Date:2005-09-01
Last Update Date:2007-10-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NH6869207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH00000661Medicaid
NH7158008001OtherCIGNA
NH0105186Y0NH01OtherANTHEM NH
NH0105186Y0NH01OtherANTHEM NH
NHRE0285Medicare PIN