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1629262944

NPI Code Detail

MEDICARE: DR. PHILLIP COX D.O.

MEDICARE: DR. PHILLIP COX D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RG0300X	Geriatric Medicine (Internal Medicine) Physician	2338	WV
2	207RP1001X	Pulmonary Disease Physician	2338	WV
3	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	2338	WV

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	WV3298A	OTHER	WV	MEDICARE PTAN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1629262944
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PHILLIP COX D.O.

Provider Business Mailing Address
First Line	:	4619 KANAWHA AVE SW
Second Line	:
City	:	SOUTH CHARLESTON
State	:	WV
Zip	:	25309-1319
Country	:	US
Telephone Number	:	304-400-4545
Fax Number	:	304-400-4546

Provider Business Practice Location Address
First Line	:	4619 KANAWHA AVE SW
Second Line	:
City	:	SOUTH CHARLESTON
State	:	WV
Zip	:	25309-1319
Country	:	US
Telephone Number	:	304-400-4545
Fax Number	:	304-400-4546

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/29/2007
Last Update Date	:	11/20/2020

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Directions to “ DR. PHILLIP COX D.O.” Practice Location

Language	Start Address	Practice Location

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