Healthcare Provider Details

I. General information

NPI: 1366655490
Provider Name (Legal Business Name): CHARLES B COX MDPC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/07/2007
Last Update Date: 04/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

503 W MADISON AVE
ATHENS TN
37303-3489
US

IV. Provider business mailing address

503 W MADISON AVE
ATHENS TN
37303-3489
US

V. Phone/Fax

Practice location:
  • Phone: 423-745-2312
  • Fax: 423-746-0687
Mailing address:
  • Phone: 423-745-2312
  • Fax: 423-746-0687

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberMD0000018827
License Number StateTN

VIII. Authorized Official

Name: DR. CHARLES B COX
Title or Position: PRINCIPAL
Credential:
Phone: 423-745-2312