Provider Demographics
NPI:1285006635
Name:COX, JUSTIN LINK (PA)
Entity Type:Individual
Prefix:
First Name:JUSTIN
Middle Name:LINK
Last Name:COX
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:203 N CEDAR AVE
Mailing Address - Street 2:
Mailing Address - City:COOKEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38501-2498
Mailing Address - Country:US
Mailing Address - Phone:931-528-1992
Mailing Address - Fax:931-526-3694
Practice Address - Street 1:203 N CEDAR AVE
Practice Address - Street 2:
Practice Address - City:COOKEVILLE
Practice Address - State:TN
Practice Address - Zip Code:38501-2498
Practice Address - Country:US
Practice Address - Phone:931-528-1992
Practice Address - Fax:931-526-3694
Is Sole Proprietor?:No
Enumeration Date:2015-10-26
Last Update Date:2016-03-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN2865363AS0400X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant