Randall Lane Wilcoxen in Peoria - Physician Assistant
Randall Lane Wilcoxen - NPI 1851363022
Randall Lane Wilcoxen is a Physician Assistant in Peoria, Illinois. Randall Lane Wilcoxen practices all healthcare services and medical treatments related to Physician Assistant. The NPI Number for Randall Lane Wilcoxen is 1851363022. The last update date is 2015-01-23.
Randall Lane Wilcoxen's current location address is 5114 N Glen Park Place Rd, Peoria, Illinois. You can contact this provider via phone number 3096832402 and fax number 3096832419. The mailing address for Randall Lane Wilcoxen is 5114 N Glen Park Place Rd, Peoria, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Randall Lane Wilcoxen |
|---|---|
| Address | 5114 N Glen Park Place Rd, Peoria, Illinois |
| Phone Number | 3096832402 |
| Fax Number | 3096832419 |
| Sole Proprietor | N |
| Credentials | PAC |
NPI Number Detail
| NPI Number | 1851363022 |
|---|---|
| Provider Enumeration Date | 2006-02-02 |
| Last Updated Date | 2015-01-23 |
Provider Mailing Address Detail
| Address | 5114 N Glen Park Place Rd |
|---|---|
| City | Peoria |
| State | Illinois (IL) |
| Post Code | 616144686 |
| Phone Number | 3096832402 |
| Fax Number | 3096832419 |
Provider's Primary Taxonomy Detail
| Speciality | Physician Assistant |
|---|---|
| Taxonomy | 363A00000X |
| Licence No | 85000632 |
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Definition: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perfor |
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Post Comment/ Review Below
What is the unique 10-digit identifier code issued to Randall Lane Wilcoxen by the Centers for Medicare & Medicaid Services?
The Randall Lane Wilcoxen has been assigned the NPI (National Provider Identifier) 1851363022 by the CMS (Centers for Medicare & Medicaid Services). This 10-digit code serves as a unique identification number for healthcare providers.
Could you please provide the complete street address where Randall Lane Wilcoxen is physically located?
The Randall Lane Wilcoxen is physically situated at the following address: 5114 N Glen Park Place Rd, Peoria, IL, 616144686.
What is the Randall Lane Wilcoxen's area of specialization and corresponding taxonomy classification?
The Randall Lane Wilcoxen's specialty field is Physician Assistant, and it falls under the taxonomy code 363A00000X, which categorizes healthcare providers based on their specialties.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1851363022 to Randall Lane Wilcoxen?
The Centers for Medicare & Medicaid Services originally issued the 1851363022 to Randall Lane Wilcoxen on 2006-02-02.
When was the Randall Lane Wilcoxen's information last updated?
The Randall Lane Wilcoxen's information was last updated on 2015-01-23.