Provider Demographics
NPI:1710369012
Name:COX, DOUGLAS (FNP-C)
Entity Type:Individual
Prefix:MR
First Name:DOUGLAS
Middle Name:
Last Name:COX
Suffix:
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2022 FAIRBURN RD
Mailing Address - Street 2:SUITE D
Mailing Address - City:DOUGLASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30135-1062
Mailing Address - Country:US
Mailing Address - Phone:770-942-1044
Mailing Address - Fax:770-942-1699
Practice Address - Street 1:2022 FAIRBURN RD
Practice Address - Street 2:SUITE D
Practice Address - City:DOUGLASVILLE
Practice Address - State:GA
Practice Address - Zip Code:30135-1062
Practice Address - Country:US
Practice Address - Phone:770-942-1044
Practice Address - Fax:770-942-1699
Is Sole Proprietor?:No
Enumeration Date:2015-06-23
Last Update Date:2015-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN206906363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily