Healthcare Provider Details

I. General information

NPI: 1326976275
Provider Name (Legal Business Name): JACK ANDREW COX
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2026
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2811 N 2350 W
OGDEN UT
84404-5177
US

IV. Provider business mailing address

1534 LEOLA ST
KAYSVILLE UT
84037-9443
US

V. Phone/Fax

Practice location:
  • Phone: 801-452-1940
  • Fax: 801-872-8757
Mailing address:
  • Phone:
  • Fax: 801-872-8757

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: