Provider Demographics
NPI:1114912094
Name:COX, W WILLIAM ANDREW (MD)
Entity Type:Individual
Prefix:
First Name:W WILLIAM
Middle Name:ANDREW
Last Name:COX
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:W. WILLIAM
Other - Middle Name:ANDREW
Other - Last Name:COX
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1640 COWLES ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:FAIRBANKS
Mailing Address - State:AK
Mailing Address - Zip Code:99701
Mailing Address - Country:US
Mailing Address - Phone:907-452-4768
Mailing Address - Fax:907-452-1009
Practice Address - Street 1:1640 COWLES ST
Practice Address - Street 2:
Practice Address - City:SUITE 1
Practice Address - State:AK
Practice Address - Zip Code:99701-5992
Practice Address - Country:US
Practice Address - Phone:907-452-4768
Practice Address - Fax:907-452-1009
Is Sole Proprietor?:No
Enumeration Date:2005-09-15
Last Update Date:2020-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK5382207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKMD 69431Medicaid
AKK162481Medicare PIN
AKK160114Medicare ID - Type Unspecified
AKMD 69431Medicaid