Provider Demographics
NPI:1609059658
Name:COX FAMILY MEDICINE, INC
Entity Type:Organization
Organization Name:COX FAMILY MEDICINE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:N
Authorized Official - Last Name:COX
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:912-632-6000
Mailing Address - Street 1:210 E 16TH ST
Mailing Address - Street 2:
Mailing Address - City:ALMA
Mailing Address - State:GA
Mailing Address - Zip Code:31510-2912
Mailing Address - Country:US
Mailing Address - Phone:912-632-6000
Mailing Address - Fax:912-632-6002
Practice Address - Street 1:210 E 16TH ST
Practice Address - Street 2:
Practice Address - City:ALMA
Practice Address - State:GA
Practice Address - Zip Code:31510-2912
Practice Address - Country:US
Practice Address - Phone:912-632-6000
Practice Address - Fax:912-632-6002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-13
Last Update Date:2022-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA042034207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000743432NMedicaid
GA000743432MMedicaid
GA000743432LMedicaid
GAGRP6965OtherMEDICARE GRP PROVIDER #