Healthcare Provider Details

I. General information

NPI: 1770850059
Provider Name (Legal Business Name): DAVID B COX
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/30/2011
Last Update Date: 01/11/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 N MAIN ST
GORDONSVILLE VA
22942-9137
US

IV. Provider business mailing address

501 N MAIN ST
GORDONSVILLE VA
22942-9137
US

V. Phone/Fax

Practice location:
  • Phone: 540-832-2211
  • Fax: 540-832-2293
Mailing address:
  • Phone: 540-832-2211
  • Fax: 540-832-2293

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number0101033199
License Number StateVA

VIII. Authorized Official

Name: DR. DAVID B COX
Title or Position: OWNER
Credential: M.D.
Phone: 540-832-2211