Provider Demographics
NPI:1679863419
Name:WILCOX, CLIFTON (MD)
Entity type:Individual
Prefix:
First Name:CLIFTON
Middle Name:
Last Name:WILCOX
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7700 ARLINGTON BLVD STE 5113
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22042-5190
Mailing Address - Country:US
Mailing Address - Phone:703-681-9126
Mailing Address - Fax:
Practice Address - Street 1:7700 ARLINGTON BLVD STE 5113
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22042-5190
Practice Address - Country:US
Practice Address - Phone:703-681-9126
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-13
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101248669208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice