Provider Demographics
NPI:1679036826
Name:COX, TAYLOR (DC)
Entity Type:Individual
Prefix:
First Name:TAYLOR
Middle Name:
Last Name:COX
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1319 MILITARY CUTOFF RD STE LL
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28405-3640
Mailing Address - Country:US
Mailing Address - Phone:910-256-9115
Mailing Address - Fax:
Practice Address - Street 1:1319 MILITARY CUTOFF RD STE LL
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28405-3640
Practice Address - Country:US
Practice Address - Phone:910-256-9115
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-12
Last Update Date:2019-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5006111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5006Medicaid