Provider Demographics
NPI:1922126507
Name:COX, JENNIFER ELAINE (MD)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:ELAINE
Last Name:COX
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2025 N MOUNT JULIET RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MOUNT JULIET
Mailing Address - State:TN
Mailing Address - Zip Code:37122-3933
Mailing Address - Country:US
Mailing Address - Phone:615-754-7337
Mailing Address - Fax:615-754-7338
Practice Address - Street 1:2025 N MOUNT JULIET RD
Practice Address - Street 2:SUITE 200
Practice Address - City:MOUNT JULIET
Practice Address - State:TN
Practice Address - Zip Code:37122-3933
Practice Address - Country:US
Practice Address - Phone:615-754-7337
Practice Address - Fax:615-754-7338
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2013-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD42085208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN5441626Medicaid