Provider Demographics
NPI:1043342298
Name:COX, STEVEN FIFE (DC)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:FIFE
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:PO BOX 12481
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:TN
Mailing Address - Zip Code:38308-0143
Mailing Address - Country:US
Mailing Address - Phone:731-616-8949
Mailing Address - Fax:
Practice Address - Street 1:189 W UNIVERSITY PKWY
Practice Address - Street 2:SUITE C
Practice Address - City:JACKSON
Practice Address - State:TN
Practice Address - Zip Code:38305-1658
Practice Address - Country:US
Practice Address - Phone:731-616-8949
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-12
Last Update Date:2012-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS1012111N00000X
TNDC0000002201111N00000X
TNDC 2201171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MSU76869Medicare UPIN