Provider Demographics
NPI:1205862117
Name:COX, DANIEL EARL (MD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:EARL
Last Name:COX
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:THREE ST. ELIZABETH'S BLVD.
Mailing Address - Street 2:STE. 2800
Mailing Address - City:O'FALLON
Mailing Address - State:IL
Mailing Address - Zip Code:62269-1099
Mailing Address - Country:US
Mailing Address - Phone:618-233-6044
Mailing Address - Fax:618-233-5195
Practice Address - Street 1:THREE ST. ELIZABETH'S BLVD.
Practice Address - Street 2:STE. 2800
Practice Address - City:O'FALLON
Practice Address - State:IL
Practice Address - Zip Code:62269-1099
Practice Address - Country:US
Practice Address - Phone:618-233-6044
Practice Address - Fax:618-233-5195
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2021-12-21
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Provider Licenses
StateLicense IDTaxonomies
IL036-1158772086S0129X
MO20070290962086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOMA1778001Medicare PIN