Provider Demographics
NPI:1649205154
Name:COX, GUY T (CNM)
Entity Type:Individual
Prefix:
First Name:GUY
Middle Name:T
Last Name:COX
Suffix:
Gender:M
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5285 S 400 E
Mailing Address - Street 2:SUITE B
Mailing Address - City:WASHINGTON TERRACE
Mailing Address - State:UT
Mailing Address - Zip Code:84405-7194
Mailing Address - Country:US
Mailing Address - Phone:801-476-7300
Mailing Address - Fax:801-476-7307
Practice Address - Street 1:5285 S 400 E
Practice Address - Street 2:SUITE B
Practice Address - City:WASHINGTON TERRACE
Practice Address - State:UT
Practice Address - Zip Code:84405-7194
Practice Address - Country:US
Practice Address - Phone:801-476-7300
Practice Address - Fax:801-476-7307
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2016-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT326060-4402176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
UTQ18408Medicare UPIN