Provider Demographics
NPI:1730158809
Name:COX, KENNETH F (PA-C)
Entity type:Individual
Prefix:MR
First Name:KENNETH
Middle Name:F
Last Name:COX
Suffix:
Gender:M
Credentials:PA-C
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Mailing Address - Street 1:PO BOX 6599
Mailing Address - Street 2:
Mailing Address - City:DOTHAN
Mailing Address - State:AL
Mailing Address - Zip Code:36302-6599
Mailing Address - Country:US
Mailing Address - Phone:334-793-2120
Mailing Address - Fax:334-671-0228
Practice Address - Street 1:4126 WEST MAIN STREET
Practice Address - Street 2:
Practice Address - City:DOTHAN
Practice Address - State:AL
Practice Address - Zip Code:36305-9310
Practice Address - Country:US
Practice Address - Phone:334-793-2120
Practice Address - Fax:334-671-0228
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2020-09-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ALPA-223363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALP38140Medicare UPIN