Provider Demographics
NPI:1629285986
Name:WAYNE E COX MD PC
Entity Type:Organization
Organization Name:WAYNE E COX MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:DR
Authorized Official - First Name:WAYNE
Authorized Official - Middle Name:ELDON
Authorized Official - Last Name:COX
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:435-637-2970
Mailing Address - Street 1:PO BOX 918
Mailing Address - Street 2:
Mailing Address - City:PRICE
Mailing Address - State:UT
Mailing Address - Zip Code:84501-0918
Mailing Address - Country:US
Mailing Address - Phone:435-637-2970
Mailing Address - Fax:435-637-9158
Practice Address - Street 1:945 WEST HOSPITAL DRVIE
Practice Address - Street 2:SUITE #3
Practice Address - City:PRICE
Practice Address - State:UT
Practice Address - Zip Code:84501-0918
Practice Address - Country:US
Practice Address - Phone:435-637-2970
Practice Address - Fax:435-637-9158
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-17
Last Update Date:2007-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT80-165115-1205208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT528646636005Medicaid
UTD07335OtherOTHER INSURANCES
UTD07335OtherOTHER INSURANCES
UT528646636005Medicaid