Provider Demographics
NPI:1598968265
Name:COX, SUZANNE RUTH (RT R M)
Entity Type:Individual
Prefix:MS
First Name:SUZANNE
Middle Name:RUTH
Last Name:COX
Suffix:
Gender:F
Credentials:RT R M
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7807 LARIAT ROAD
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40219
Mailing Address - Country:US
Mailing Address - Phone:502-742-3073
Mailing Address - Fax:
Practice Address - Street 1:7807 LARIAT ROAD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40219
Practice Address - Country:US
Practice Address - Phone:502-742-3073
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY12090044752471M2300X
MN0856402471M2300X
INXT0148152471M2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471M2300XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistMammography