Healthcare Provider Details

I. General information

NPI: 1013240688
Provider Name (Legal Business Name): TABITHA E COX PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2009
Last Update Date: 02/24/2025
Certification Date: 02/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

218 UNDERCLIFF TER
PRINCETON WV
24740-2176
US

IV. Provider business mailing address

218 UNDERCLIFF TER
PRINCETON WV
24740-2176
US

V. Phone/Fax

Practice location:
  • Phone: 304-327-1890
  • Fax: 304-325-1908
Mailing address:
  • Phone: 304-327-1890
  • Fax: 304-325-1908

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number2091
License Number StateWV
# 2
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number475
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: