Provider Demographics
NPI:1619548302
Name:GARY W. COX MD A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:GARY W. COX MD A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GARY
Authorized Official - Middle Name:W
Authorized Official - Last Name:COX
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:225-532-4058
Mailing Address - Street 1:4460 BLUEBONNET BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70809-9658
Mailing Address - Country:US
Mailing Address - Phone:225-300-9399
Mailing Address - Fax:225-659-8031
Practice Address - Street 1:4460 BLUEBONNET BLVD STE A
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809-9658
Practice Address - Country:US
Practice Address - Phone:225-300-9399
Practice Address - Fax:225-659-8031
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-05
Last Update Date:2021-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Single Specialty