Healthcare Provider Details

I. General information

NPI: 1700284163
Provider Name (Legal Business Name): COX FAMILY PRACTICE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/16/2014
Last Update Date: 12/16/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2015 MAIN STREET
HOPE AR
71801
US

IV. Provider business mailing address

PO BOX 1348 2015 MAIN STREET
HOPE AR
71801
US

V. Phone/Fax

Practice location:
  • Phone: 870-777-0007
  • Fax: 870-777-0061
Mailing address:
  • Phone: 870-777-0007
  • Fax: 870-777-0061

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License NumberA004221
License Number StateAR
# 2
Primary TaxonomyN
Taxonomy Code305R00000X
TaxonomyPreferred Provider Organization
License NumberA004221
License Number StateAR

VIII. Authorized Official

Name: KIRSTEN KAYE COX
Title or Position: FAMILY NURSE PRACTITIONER
Credential: ARNP, CNP
Phone: 870-777-0007