Provider Demographics
NPI:1063773638
Name:COX, JOHNNY LEE II
Entity type:Individual
Prefix:MR
First Name:JOHNNY
Middle Name:LEE
Last Name:COX
Suffix:II
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 SABLE DR
Mailing Address - Street 2:
Mailing Address - City:GOLDSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27530-9024
Mailing Address - Country:US
Mailing Address - Phone:919-394-2092
Mailing Address - Fax:
Practice Address - Street 1:208 SABLE DR
Practice Address - Street 2:
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27530-9024
Practice Address - Country:US
Practice Address - Phone:919-394-2092
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-31
Last Update Date:2012-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health