1700129111 NPI number — DR. AMANDA PYSHER COX M.D.

Table of content: DR. AMANDA PYSHER COX M.D. (NPI 1700129111)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1700129111 NPI number — DR. AMANDA PYSHER COX M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
COX
Provider First Name:
AMANDA
Provider Middle Name:
PYSHER
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
PYSHER
Provider Other First Name:
AMANDA
Provider Other Middle Name:
CRISSEY
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
MD
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1700129111
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/13/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
LEWIS-GALE PHYSICIANS, LLC
Provider Second Line Business Mailing Address:
1802 BRAEBURN DRIVE
Provider Business Mailing Address City Name:
SALEM
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
24153
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
540-772-3407
Provider Business Mailing Address Fax Number:
540-725-5067

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1802 BRAEBURN DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SALEM
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
24153-7357
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
540-772-3671
Provider Business Practice Location Address Fax Number:
540-725-5067
Provider Enumeration Date:
04/03/2013

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: 208600000X , with the licence number:  0101265064 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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