Provider Demographics
NPI:1427193697
Name:COX CHIROPRACTIC, INC.
Entity Type:Organization
Organization Name:COX CHIROPRACTIC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:COX
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:337-474-9400
Mailing Address - Street 1:PO BOX 3084
Mailing Address - Street 2:
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70602-3084
Mailing Address - Country:US
Mailing Address - Phone:337-436-7560
Mailing Address - Fax:337-433-9861
Practice Address - Street 1:540 W MCNEESE ST
Practice Address - Street 2:
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70605-5528
Practice Address - Country:US
Practice Address - Phone:337-474-9400
Practice Address - Fax:337-474-0640
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA859111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
U06294Medicare UPIN
LA5S800Medicare ID - Type UnspecifiedGROUP