Dr. Kenneth Robert Wilcox
Cardiothoracic Vascular Surgeon
720 Madison Ave
Scranton
, Pennsylvania 18510-1609
Dr. Kenneth Robert Wilcox
Cardiothoracic Vascular Surgeon
720 Madison Ave
Scranton
, Pennsylvania 18510-1609
(570) 343-1115
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About
Features
Specialties
- Cardiothoracic Vascular Surgeon
Languages spoken
- English
Location
First Address
- Dr. Kenneth Robert Wilcox
- 720 Madison Ave
- Scranton, PA
- Zip : 18510-1609
- Phone : (570) 343-1115
Second Address
- Dr. Kenneth Robert Wilcox
- 720 Madison Ave
- Scranton, PA
- Zip : 18510-1609
- Phone : (570) 343-1115
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 208G00000X | Cardiothoracic Vascular Surgeon | MD040998E | PA |
National Provider Identifier
| NPI | 1043381379 |
|---|---|
| Provider Name | Dr. Kenneth Robert Wilcox |
| First Address | Scranton, PA 18510-1609 |
| Second Address | Scranton, PA 18510-1609 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 10/11/2006 |
| Last Update Date | 08/07/2007 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| C27735 | (02) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.