Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 0104000295 | VA |
N | 111NX0800X | Chiropractor Orthopedic Specialist | 0104000295 | VA |
NPI | 1669586210 |
---|---|
Provider Name | Douglas Mark Cox |
First Address | Charlottesville, VA 22902-5374 |
Second Address | Charlottesville, VA 22902-5374 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/08/2006 |
Last Update Date | 19/01/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
067070 | ANTHEM (01) | VA |
22986400001 | SOUTHERN HEALTH (01) | VA |
2396894 | CIGNA (01) | VA |
T21778 | (02) | VA |