Provider Demographics
NPI:1417204801
Name:COX, JARED CHRISTOPHER (OD)
Entity Type:Individual
Prefix:DR
First Name:JARED
Middle Name:CHRISTOPHER
Last Name:COX
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1310
Mailing Address - Street 2:
Mailing Address - City:TRUSSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35173-6102
Mailing Address - Country:US
Mailing Address - Phone:864-314-6469
Mailing Address - Fax:
Practice Address - Street 1:1686 MONTGOMERY HWY
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35216-4906
Practice Address - Country:US
Practice Address - Phone:205-979-2020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-06
Last Update Date:2014-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALR231TA992152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist