Provider Demographics
NPI:1659352995
Name:COX, RICHARD B (DO)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:B
Last Name:COX
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10330 N MERIDIAN ST # 300
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46290-1024
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1214 E NATIONAL AVE STE 100
Practice Address - Street 2:
Practice Address - City:BRAZIL
Practice Address - State:IN
Practice Address - Zip Code:47834-2700
Practice Address - Country:US
Practice Address - Phone:812-442-2820
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-11
Last Update Date:2017-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN02001988A207V00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200243120Medicaid
ING73267Medicare UPIN
IN090540040Medicare PIN
IN153886Medicare Oscar/Certification
IN204330Medicare Oscar/Certification
IN090540040Medicare PIN
2008894200OtherMEDICAID RURAL HEALTH-GROUP
IN200153250AMedicaid