Glen Paul Wilcoxson, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

5915 Issued in AL

Practice address

1 Timber Way
Ste 102
Daphne, AL 36527

Phone

(251) 447-0333

Fax

(251) 447-0009

NPI assigned

Feb 21, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1689719890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 TIMBER WAY",
            "address_2": "STE 102",
            "city": "DAPHNE",
            "state": "AL",
            "postal_code": "36527",
            "telephone_number": "251-447-0333",
            "fax_number": "251-447-0009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 TIMBER WAY",
            "address_2": "STE 102",
            "city": "DAPHNE",
            "state": "AL",
            "postal_code": "36527",
            "telephone_number": "251-447-0333",
            "fax_number": "251-447-0009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILCOXSON",
        "first_name": "GLEN",
        "middle_name": "PAUL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "5915",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth M. Wharton IX, LMFT 237
• Michele S White, PT
• Stanley D White, PA
• Brittany Charlene Wickware, CRNP
• Julie Borom Wiggins, DNP, PNP, PMHS
• Danyle V Wilkinson, MA, BCBA, LBA
• Mercedes Williams-Sampey
• Ashley Williams, PHARM.D.
• Drake B. Williams, M.D.
• George Gregory Williams, PHD

• Family Medicine Physician in Daphne, AL
• Providers in Daphne, AL by specialty
• Family Medicine Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.