Provider Demographics
NPI:1144382011
Name:COX, BURTON DALE JR (DO)
Entity Type:Individual
Prefix:DR
First Name:BURTON
Middle Name:DALE
Last Name:COX
Suffix:JR
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1101 MORRISON DR
Mailing Address - Street 2:HSU
Mailing Address - City:BOSCOBEL
Mailing Address - State:WI
Mailing Address - Zip Code:53805-1180
Mailing Address - Country:US
Mailing Address - Phone:608-375-6433
Mailing Address - Fax:608-375-6439
Practice Address - Street 1:1101 MORRISON DR
Practice Address - Street 2:HSU
Practice Address - City:BOSCOBEL
Practice Address - State:WI
Practice Address - Zip Code:53805-1180
Practice Address - Country:US
Practice Address - Phone:608-375-6433
Practice Address - Fax:608-375-6439
Is Sole Proprietor?:No
Enumeration Date:2006-12-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI33222-021207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine