=====================================================
General NPI Number Information
=====================================================
NPI Number | 1649361957
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | GEORGE DOUGLAS COX PHD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/28/2006
-----------------------------------------------------
Last Update Date | 09/10/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 445 W BLOUNT AVE # 412
-----------------------------------------------------
City | KNOXVILLE
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37920
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 865-386-6392
-----------------------------------------------------
Fax | 865-314-8402
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 445 W BLOUNT AVE # 412
-----------------------------------------------------
City | KNOXVILLE
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37920
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 865-386-6392
-----------------------------------------------------
Fax | 865-314-8402
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103TS0200X
-----------------------------------------------------
Taxonomy Name | School Psychologist
-----------------------------------------------------
License Number | 894
-----------------------------------------------------
License Number State | TN
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 103TH0100X
-----------------------------------------------------
Taxonomy Name | Health Service Psychologist
-----------------------------------------------------
License Number | P0000000894
-----------------------------------------------------
License Number State | TN
-----------------------------------------------------