Healthcare Provider Details

I. General information

NPI: 1760572762
Provider Name (Legal Business Name): JIM E COX DDS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/13/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 SOUTH MAIN STREET
NEWCASTLE OK
73065
US

IV. Provider business mailing address

501 SOUTH MAIN STREET
NEWCASTLE OK
73065
US

V. Phone/Fax

Practice location:
  • Phone: 405-387-5858
  • Fax: 405-387-2034
Mailing address:
  • Phone: 405-387-5858
  • Fax: 405-387-2034

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number4352
License Number StateOK

VIII. Authorized Official

Name: DR. JIM EDWARD COX JR.
Title or Position: PRESIDENT
Credential: DDS
Phone: 405-387-5858