Provider Demographics
NPI:1114037546
Name:COX, SAM J III (MD)
Entity Type:Individual
Prefix:DR
First Name:SAM
Middle Name:J
Last Name:COX
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1964 MCCLELLAN LN
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:38138-2576
Mailing Address - Country:US
Mailing Address - Phone:901-485-9382
Mailing Address - Fax:
Practice Address - Street 1:315 S WALNUT BEND RD STE 101
Practice Address - Street 2:
Practice Address - City:CORDOVA
Practice Address - State:TN
Practice Address - Zip Code:38018-1509
Practice Address - Country:US
Practice Address - Phone:901-755-8880
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD012596207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNB59429Medicare UPIN
TN3181157Medicare PIN