Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0200X | Radiology | 08000318A | IN |
Y | 213ER0200X | Radiology | 08000318A | IN |
NPI | 1174529424 |
---|---|
Provider Name | Dr. James Monroe Cox |
First Address | Fort Wayne, IN 46805-1611 |
Second Address | Fort Wayne, IN 46805-1611 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/06/2005 |
Last Update Date | 24/03/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100366970 | (05) | IN |
T81860 | (02) | IN |