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General NPI Number Information
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NPI Number | 1871334722
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Entity Type | Individual
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Provider Name | SULLIVAN COX OWENS PA-C
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Gender | Female
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Dates
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Enumeration Date | 06/04/2024
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Last Update Date | 07/11/2025
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Provider Practice Location Address
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Address Line | 111 S GREEN RIVER RD STE F
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City | EVANSVILLE
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State | IN
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Zip | 47715-7338
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Country | US
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Telephone | 812-541-4388
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Fax |
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Provider Business Mailing Address
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Address Line | 1807 FAWN DR
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City | OWENSBORO
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State | KY
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Zip | 42303-1845
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Country | US
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Telephone | 812-604-5960
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | 10004428A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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