Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208G00000X | Cardiothoracic Vascular Surgeon | MD018119 | TN |
NPI | 1154394344 |
---|---|
Provider Name | Dr. Allen Brian Wilcox JR. |
First Address | Nashville, TN 37228-1317 |
Second Address | Nashville, TN 37203-2012 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/02/2006 |
Last Update Date | 15/02/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1527252 | (05) | TN |