Provider Demographics
NPI:1568710887
Name:DERRICK D COX M D PLLC
Entity Type:Organization
Organization Name:DERRICK D COX M D PLLC
Other - Org Name:SURGICAL ONCOLOGY SPECIALISTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DERRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:COX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-329-8229
Mailing Address - Street 1:1955 1ST AVE N
Mailing Address - Street 2:SUITE 104
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33713-8941
Mailing Address - Country:US
Mailing Address - Phone:727-329-8229
Mailing Address - Fax:727-329-8229
Practice Address - Street 1:1955 1ST AVE N
Practice Address - Street 2:SUITE 104
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33713-8941
Practice Address - Country:US
Practice Address - Phone:727-329-8229
Practice Address - Fax:727-329-8229
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-16
Last Update Date:2012-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical OncologyGroup - Single Specialty