Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 12079 | AL |
NPI | 1013951078 |
---|---|
Provider Name | Dr. Ted Russell Cox |
First Address | Winfield, AL 35594-5067 |
Second Address | Winfield, AL 35594-5067 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C74689 | (02) | AL |