Provider Demographics
NPI:1841434974
Name:WILLCOX, AMY NICOLE (DO)
Entity type:Individual
Prefix:DR
First Name:AMY
Middle Name:NICOLE
Last Name:WILLCOX
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1824 MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37043-4605
Mailing Address - Country:US
Mailing Address - Phone:931-552-6070
Mailing Address - Fax:
Practice Address - Street 1:1824 MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37043-4605
Practice Address - Country:US
Practice Address - Phone:931-552-6070
Practice Address - Fax:931-552-9896
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-20
Last Update Date:2021-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN4237207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty