MEDICARE: GUY T COX CNM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	176B00000X	Midwife	326060-4402	UT

General Provider Information

NPI Number	:	1649205154
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GUY T COX CNM

Provider Business Mailing Address
First Line	:	5285 S 400 E
Second Line	:	SUITE B
City	:	WASHINGTON TERRACE
State	:	UT
Zip	:	84405-7194
Country	:	US
Telephone Number	:	801-476-7300
Fax Number	:	801-476-7307

Provider Business Practice Location Address
First Line	:	5285 S 400 E
Second Line	:	SUITE B
City	:	WASHINGTON TERRACE
State	:	UT
Zip	:	84405-7194
Country	:	US
Telephone Number	:	801-476-7300
Fax Number	:	801-476-7307

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/12/2006
Last Update Date	:	01/28/2016

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