| Marc Luther Wilcox, MS CCC-A | |
|
280 Central Ave, W123 Thompson Hall, Fredonia, NY 14063-1127 | |
| (716) 673-3203 | |
| Not Available |
| Full Name | Marc Luther Wilcox |
|---|---|
| Gender | Male |
| Speciality | Audiologist |
| Location | 280 Central Ave, Fredonia, New York |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205855145 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 231H00000X | Audiologist | 001310-1 (New York) | Primary |
| Provider Name | State Of New York Comptrollers Office |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1508079567 PECOS PAC ID: 0840101770 Enrollment ID: O20040304000126 |
| Provider Name | Diversified Services For Occupational Therapy Physical Ther |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1447283882 PECOS PAC ID: 0143204917 Enrollment ID: O20050805000553 |
| Mailing Address | Practice Location Address |
|---|---|
| Marc Luther Wilcox, MS CCC-A 280 Central Ave, W123 Thompson Hall, Fredonia, NY 14063-1127 Ph: (716) 673-3203 | Marc Luther Wilcox, MS CCC-A 280 Central Ave, W123 Thompson Hall, Fredonia, NY 14063-1127 Ph: (716) 673-3203 |
Melanie Anne Zimmer, AUD Audiologist Medicare: May Accept Medicare Assignments Practice Location: 280 Central Ave, Fredonia, NY 14063 Phone: 716-673-3203 Fax: 716-673-3235 | |
State Of New York Comptrollers Office Audiologist Medicare: Medicare Enrolled Practice Location: 280 Central Ave, W123 Thompson Hall, Fredonia, NY 14063 Phone: 716-673-3203 Fax: 716-673-3235 |