Provider Demographics
NPI:1497712004
Name:COX, DOUGLAS RAYMOND (OD)
Entity Type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:RAYMOND
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 1:7001 S EDGERTON RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:BRECKSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44141-4206
Mailing Address - Country:US
Mailing Address - Phone:440-526-1974
Mailing Address - Fax:440-740-0662
Practice Address - Street 1:7001 S EDGERTON RD
Practice Address - Street 2:SUITE B
Practice Address - City:BRECKSVILLE
Practice Address - State:OH
Practice Address - Zip Code:44141-4206
Practice Address - Country:US
Practice Address - Phone:440-526-1974
Practice Address - Fax:440-740-0662
Is Sole Proprietor?:No
Enumeration Date:2006-04-27
Last Update Date:2020-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3336/T391152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0422082Medicaid
OH0126660001Medicare NSC
T78484Medicare UPIN
OH0489192Medicare PIN