=====================================================
General NPI Number Information
=====================================================
NPI Number | 1134539802
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JAMES ROBERT COX
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/05/2014
-----------------------------------------------------
Last Update Date | 05/05/2014
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1429 N. MAIN
-----------------------------------------------------
City | JAY
-----------------------------------------------------
State | OK
-----------------------------------------------------
Zip | 74346
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 405-610-3644
-----------------------------------------------------
Fax | 405-610-3647
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 351 N. AIR DEPOT STE. M
-----------------------------------------------------
City | MIDWEST CITY
-----------------------------------------------------
State | OK
-----------------------------------------------------
Zip | 73110
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 405-610-3644
-----------------------------------------------------
Fax | 405-610-3647
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103K00000X
-----------------------------------------------------
Taxonomy Name | Behavior Analyst
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------