Provider Demographics
NPI:1225863699
Name:COX, REAGAN (PA-C)
Entity type:Individual
Prefix:
First Name:REAGAN
Middle Name:
Last Name:COX
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 CARTERS CT
Mailing Address - Street 2:
Mailing Address - City:BAINBRIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:39819-9003
Mailing Address - Country:US
Mailing Address - Phone:229-400-1603
Mailing Address - Fax:
Practice Address - Street 1:340 KENNESTONE HOSPITAL BLVD STE 100
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-1158
Practice Address - Country:US
Practice Address - Phone:770-281-5100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-05
Last Update Date:2024-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant