Healthcare Provider Details

I. General information

NPI: 1205768249
Provider Name (Legal Business Name): HALLIE LORENE COX OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/02/2026
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

710 W SUPERIOR ST STE A
SANDPOINT ID
83864-1684
US

IV. Provider business mailing address

710 W SUPERIOR ST STE A
SANDPOINT ID
83864-1684
US

V. Phone/Fax

Practice location:
  • Phone: 208-263-9000
  • Fax:
Mailing address:
  • Phone: 208-263-9000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number2481714
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: