Provider Demographics
NPI:1396763389
Name:COX, JOHN ALFRED JR (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:ALFRED
Last Name:COX
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:4417 W GORE BLVD
Mailing Address - Street 2:#5
Mailing Address - City:LAWTON
Mailing Address - State:OK
Mailing Address - Zip Code:73505-6023
Mailing Address - Country:US
Mailing Address - Phone:580-248-0110
Mailing Address - Fax:580-357-9103
Practice Address - Street 1:4417 W GORE BLVD
Practice Address - Street 2:#5
Practice Address - City:LAWTON
Practice Address - State:OK
Practice Address - Zip Code:73505-5978
Practice Address - Country:US
Practice Address - Phone:580-248-0110
Practice Address - Fax:580-357-9103
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2014-01-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OK15139207RC0200X, 207RP1001X, 207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100112630AMedicaid
OK100112630AMedicaid