Provider Demographics
NPI:1417482761
Name:COX, JEFFREY LYNN (PA-C)
Entity type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:LYNN
Last Name:COX
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1579 W GURLEY ST STE A-39
Mailing Address - Street 2:
Mailing Address - City:PRESCOTT
Mailing Address - State:AZ
Mailing Address - Zip Code:86305-2829
Mailing Address - Country:US
Mailing Address - Phone:928-440-2080
Mailing Address - Fax:928-440-8141
Practice Address - Street 1:1579 W GURLEY ST STE A-39
Practice Address - Street 2:
Practice Address - City:PRESCOTT
Practice Address - State:AZ
Practice Address - Zip Code:86305-2829
Practice Address - Country:US
Practice Address - Phone:928-440-2080
Practice Address - Fax:928-440-8141
Is Sole Proprietor?:No
Enumeration Date:2017-04-25
Last Update Date:2025-06-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ10385363A00000X
CA55098363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant