Provider Demographics
NPI:1720716152
Name:COX, PHILIP BRIAN (FNP-C)
Entity type:Individual
Prefix:MR
First Name:PHILIP
Middle Name:BRIAN
Last Name:COX
Suffix:
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:221 LANE PKWY STE B
Mailing Address - Street 2:
Mailing Address - City:SHELBYVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37160-3108
Mailing Address - Country:US
Mailing Address - Phone:931-773-3030
Mailing Address - Fax:931-236-2056
Practice Address - Street 1:221 LANE PKWY STE B
Practice Address - Street 2:
Practice Address - City:SHELBYVILLE
Practice Address - State:TN
Practice Address - Zip Code:37160-3108
Practice Address - Country:US
Practice Address - Phone:931-773-3030
Practice Address - Fax:931-236-2056
Is Sole Proprietor?:No
Enumeration Date:2022-08-12
Last Update Date:2024-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN32211363LF0000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1598528313OtherGROUP NPI
TNQ079493Medicaid