Provider Demographics
NPI:1619064524
Name:COX, PHILLIP R (DMD, MS)
Entity Type:Individual
Prefix:DR
First Name:PHILLIP
Middle Name:R
Last Name:COX
Suffix:
Gender:M
Credentials:DMD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2045 BROOKWOOD MEDICAL CTR DR
Mailing Address - Street 2:SUITE 1
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35209-6874
Mailing Address - Country:US
Mailing Address - Phone:205-879-1765
Mailing Address - Fax:
Practice Address - Street 1:2045 BROOKWOOD MEDICAL CTR DR
Practice Address - Street 2:SUITE 1
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35209-6874
Practice Address - Country:US
Practice Address - Phone:205-879-1765
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL40101223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics