Provider Demographics
NPI:1972556637
Name:WILCOX, HOWARD LEA JR (MD)
Entity Type:Individual
Prefix:
First Name:HOWARD
Middle Name:LEA
Last Name:WILCOX
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:20805 WEST 151ST
Mailing Address - Street 2:SUITE 224
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66061
Mailing Address - Country:US
Mailing Address - Phone:913-390-1800
Mailing Address - Fax:913-782-8813
Practice Address - Street 1:20805 WEST 151ST
Practice Address - Street 2:SUITE 224
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66061
Practice Address - Country:US
Practice Address - Phone:913-390-1800
Practice Address - Fax:913-782-8813
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2009-11-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KS0414758207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100086140BMedicaid
KS033C5460Medicare ID - Type Unspecified
KS100086140BMedicaid