Provider Demographics
NPI:1629140736
Name:COX, EDGAR L (MD)
Entity Type:Individual
Prefix:
First Name:EDGAR
Middle Name:L
Last Name:COX
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 11647
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89510-1647
Mailing Address - Country:US
Mailing Address - Phone:775-770-3930
Mailing Address - Fax:775-770-3939
Practice Address - Street 1:6770 S MCCARRAN BLVD
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89509-6103
Practice Address - Country:US
Practice Address - Phone:775-853-3333
Practice Address - Fax:775-851-0246
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV7693207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVPENDINGMedicaid
NVPENDINGMedicare ID - Type Unspecified
NVE58547Medicare UPIN