1669418612 NPI number — JOHN M COX DO

Table of content: JOHN M COX DO (NPI 1669418612)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1669418612 NPI number — JOHN M COX DO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
COX
Provider First Name:
JOHN
Provider Middle Name:
M
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
DO
Provider Gender Code:
M

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:
1669418612
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/11/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 3810
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
JOPLIN
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
64803
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
417-347-5000
Provider Business Mailing Address Fax Number:
417-347-6454

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1102 WEST 32ND STREET
Provider Second Line Business Practice Location Address:
STE 300
Provider Business Practice Location Address City Name:
JOPLIN
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
64804
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
417-347-5000
Provider Business Practice Location Address Fax Number:
417-347-6454
Provider Enumeration Date:
06/20/2006

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: 207RC0000X , with the licence number:  R8C17 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 100185690A , issued by the state of ( OK ) . This identifiers is of the category "MEDICAID".
  • Identifier: 100235140C , issued by the state of ( KS ) . This identifiers is of the category "MEDICAID".
  • Identifier: 241867530 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7688 . This is a "ANTHEM" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 703068 . This is a "KS BCBS" identifier , issued by the state of ( KS ) . This identifiers is of the category "OTHER".
  • Identifier: 060026682 . This is a "RR MEDICARE" identifier . This identifiers is of the category "OTHER".




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