Provider Demographics
NPI:1710179155
Name:RANDY J COX,MDPSC
Entity Type:Organization
Organization Name:RANDY J COX,MDPSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:270-926-6867
Mailing Address - Street 1:2315 MAYFAIR DR
Mailing Address - Street 2:
Mailing Address - City:OWENSBORO
Mailing Address - State:KY
Mailing Address - Zip Code:42301-4557
Mailing Address - Country:US
Mailing Address - Phone:270-926-6864
Mailing Address - Fax:270-685-4717
Practice Address - Street 1:2315 MAYFAIR DR
Practice Address - Street 2:
Practice Address - City:OWENSBORO
Practice Address - State:KY
Practice Address - Zip Code:42301-4557
Practice Address - Country:US
Practice Address - Phone:270-926-6864
Practice Address - Fax:270-685-4717
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-09
Last Update Date:2007-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY212052084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64212153Medicaid
KY64212153Medicaid