Provider Demographics
NPI:1437260650
Name:COX, TIMOTHY CLYDE (MD)
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:CLYDE
Last Name:COX
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:560 W MITCHELL ST
Mailing Address - Street 2:SUITE 185
Mailing Address - City:PETOSKEY
Mailing Address - State:MI
Mailing Address - Zip Code:49770-2275
Mailing Address - Country:US
Mailing Address - Phone:231-487-3390
Mailing Address - Fax:231-487-3578
Practice Address - Street 1:560 W MITCHELL ST
Practice Address - Street 2:SUITE 185
Practice Address - City:PETOSKEY
Practice Address - State:MI
Practice Address - Zip Code:49770-2275
Practice Address - Country:US
Practice Address - Phone:231-487-3390
Practice Address - Fax:231-487-3578
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301054609207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1107400651OtherBCBSM
9808309002OtherCIGNA
101352OtherCARE CHOICES
110G410290OtherBCN
G37559OtherHAP
MI352354310Medicaid
G37559OtherHAP
MI1107400651OtherBCBSM
110G410290OtherBCN