Provider Demographics
NPI:1235138181
Name:COX, THOMAS P (MD)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:P
Last Name:COX
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7933 HIDDEN VW
Mailing Address - Street 2:
Mailing Address - City:HOLLAND
Mailing Address - State:OH
Mailing Address - Zip Code:43528-7918
Mailing Address - Country:US
Mailing Address - Phone:419-367-1199
Mailing Address - Fax:
Practice Address - Street 1:7933 HIDDEN VW
Practice Address - Street 2:
Practice Address - City:HOLLAND
Practice Address - State:OH
Practice Address - Zip Code:43528-7918
Practice Address - Country:US
Practice Address - Phone:419-367-1199
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-21
Last Update Date:2020-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301075206207Q00000X
NC2014-00867207Q00000X
OH35.075311CTR207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH01-05160OtherUHC
OH000000141252OtherANTHEM
OH03669OtherPARAMOUNT
OH2165133Medicaid
OH2341040OtherAETNA
OH80160100OtherRRMC
OH80160100OtherRRMC
OH2341040OtherAETNA