Provider Demographics
NPI:1427134576
Name:COX, DOUGLAS B (DC)
Entity type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:B
Last Name:COX
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1505 BUSINESS HWY 18-151 E
Mailing Address - Street 2:
Mailing Address - City:MT. HOREB
Mailing Address - State:WI
Mailing Address - Zip Code:53572
Mailing Address - Country:US
Mailing Address - Phone:608-437-5585
Mailing Address - Fax:
Practice Address - Street 1:1505 BUSINESS HWY 18-151 E
Practice Address - Street 2:
Practice Address - City:MT. HOREB
Practice Address - State:WI
Practice Address - Zip Code:53572
Practice Address - Country:US
Practice Address - Phone:608-437-5585
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1255-012111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI000335795Medicare ID - Type Unspecified
WIT61698Medicare UPIN