Doctor Name: | DR. ROGER V COX |
NPI Number: | 1104038488 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD, EDD |
License Number: | A79828 |
Business Practice Address: | 1408 North St Suite 4 Susanville, CA - 961304082 |
Business Phone Number: | 5302518511 |
Business Fax Number: | |
Mailing Address: | Po Box 270543, SUSANVILLE |
State: | CA |
Postal Code: | 961270010 |
Phone Number: | 5302518511 |
Fax Number: | |
NPI Enumeration Date: | 05/07/2007 |
NPI Last Update Date: | 07/29/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | A79828 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |