Provider Demographics
NPI:1235558834
Name:COX, JACOB LAWSON (MD)
Entity Type:Individual
Prefix:DR
First Name:JACOB
Middle Name:LAWSON
Last Name:COX
Suffix:
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 1:596 OCOEE COMMERCE PARKWAY
Mailing Address - Street 2:
Mailing Address - City:OCOEE
Mailing Address - State:FL
Mailing Address - Zip Code:34761-4219
Mailing Address - Country:US
Mailing Address - Phone:407-654-3505
Mailing Address - Fax:407-654-4956
Practice Address - Street 1:596 OCOEE COMMERCE PARKWAY
Practice Address - Street 2:
Practice Address - City:OCOEE
Practice Address - State:FL
Practice Address - Zip Code:34761-4219
Practice Address - Country:US
Practice Address - Phone:407-654-3505
Practice Address - Fax:407-654-4956
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-10
Last Update Date:2020-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME146771207X00000X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL106779200Medicaid