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 1:87 STATE ROUTE 89
Mailing Address - Street 2:
Mailing Address - City:CHINO VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:86323-5687
Mailing Address - Country:US
Mailing Address - Phone:928-404-1488
Mailing Address - Fax:866-232-8580
Practice Address - Street 1:87 STATE ROUTE 89
Practice Address - Street 2:
Practice Address - City:CHINO VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:86323-5687
Practice Address - Country:US
Practice Address - Phone:928-404-1488
Practice Address - Fax:866-232-8580
Is Sole Proprietor?:No
Enumeration Date:2017-04-25
Last Update Date:2024-05-30
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