Provider Demographics
NPI:1639349673
Name:COX, FRED HUGO (LPN)
Entity Type:Individual
Prefix:
First Name:FRED
Middle Name:HUGO
Last Name:COX
Suffix:
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 FAITH ANN DR
Mailing Address - Street 2:
Mailing Address - City:PATASKALA
Mailing Address - State:OH
Mailing Address - Zip Code:43062-7043
Mailing Address - Country:US
Mailing Address - Phone:740-927-0168
Mailing Address - Fax:
Practice Address - Street 1:600 FAITH ANN DR
Practice Address - Street 2:
Practice Address - City:PATASKALA
Practice Address - State:OH
Practice Address - Zip Code:43062-7043
Practice Address - Country:US
Practice Address - Phone:740-927-0168
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-05
Last Update Date:2008-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN118630164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse