Provider Demographics
NPI:1841230943
Name:COX, SAMUEL W (DPM)
Entity Type:Individual
Prefix:
First Name:SAMUEL
Middle Name:W
Last Name:COX
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2970 NORTH LITCHFIELD ROAD
Mailing Address - Street 2:SUITE 120
Mailing Address - City:GOODYEAR
Mailing Address - State:AZ
Mailing Address - Zip Code:85395
Mailing Address - Country:US
Mailing Address - Phone:623-935-5780
Mailing Address - Fax:623-935-5783
Practice Address - Street 1:2970 NORTH LITCHFIELD ROAD
Practice Address - Street 2:SUITE 120
Practice Address - City:GOODYEAR
Practice Address - State:AZ
Practice Address - Zip Code:85395
Practice Address - Country:US
Practice Address - Phone:623-935-5780
Practice Address - Fax:623-935-5783
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2009-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ0612213E00000X, 213EP1101X, 213ES0103X, 213ES0131X
GAPOD000671213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
No213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ118209OtherMEDICARE PTAN
AZU34114Medicare UPIN
AZ6135450001Medicare NSC