1811137896 NPI number — TIFFANY RENEE COX B.S.

Table of content: TIFFANY RENEE COX B.S. (NPI 1811137896)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1811137896 NPI number — TIFFANY RENEE COX B.S.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
COX
Provider First Name:
TIFFANY
Provider Middle Name:
RENEE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
B.S.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1811137896
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/03/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
109 CHESTNUT CT
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CROSSVILLE
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
38555
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
931-267-4809
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
21 E STANLEY ST
Provider Second Line Business Practice Location Address:
STE 103
Provider Business Practice Location Address City Name:
CROSSVILLE
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
38555-3200
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
931-267-4809
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/03/2009

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 171M00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)