Provider Demographics
NPI:1669833265
Name:BOX, AUSTIN COY (PA-C)
Entity Type:Individual
Prefix:MR
First Name:AUSTIN
Middle Name:COY
Last Name:BOX
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
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Mailing Address - Street 1:2410 SUSANNAH STREET
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37601
Mailing Address - Country:US
Mailing Address - Phone:423-282-9011
Mailing Address - Fax:423-722-0264
Practice Address - Street 1:2410 SUSANNAH STREET
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37601
Practice Address - Country:US
Practice Address - Phone:423-282-9011
Practice Address - Fax:423-722-0264
Is Sole Proprietor?:No
Enumeration Date:2016-03-10
Last Update Date:2019-12-16
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical