Healthcare Provider Details

I. General information

NPI: 1770815938
Provider Name (Legal Business Name): COX REGIONAL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/12/2010
Last Update Date: 02/12/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

815 N LINCOLN AVE STE D
MONETT MO
65708-1641
US

IV. Provider business mailing address

PO BOX 4046
SPRINGFIELD MO
65808-4046
US

V. Phone/Fax

Practice location:
  • Phone: 417-236-2475
  • Fax: 417-354-1458
Mailing address:
  • Phone: 417-269-5712
  • Fax: 417-269-4869

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: DAVID P TAYLOR
Title or Position: V.P. REGIONAL SERVICES
Credential:
Phone: 417-269-4320