Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 49121561205 | UT |
N | 207VX0000X | Obstetrician | 49121561205 | UT |
NPI | 1396770533 |
---|---|
Provider Name | Gina B. Cox |
First Address | Salt Lake City, UT 84121-6923 |
Second Address | Salt Lake City, UT 84121-6923 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/07/2006 |
Last Update Date | 23/12/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H48038 | (02) | UT |