Provider Demographics
NPI:1932330065
Name:INTERNAL MEDICINE ASSOCIATES LLC
Entity Type:Organization
Organization Name:INTERNAL MEDICINE ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:W
Authorized Official - Last Name:COX
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:662-524-4386
Mailing Address - Street 1:830 MEDICAL CENTER DR
Mailing Address - Street 2:
Mailing Address - City:WEST POINT
Mailing Address - State:MS
Mailing Address - Zip Code:39773-9319
Mailing Address - Country:US
Mailing Address - Phone:662-524-4386
Mailing Address - Fax:662-391-2947
Practice Address - Street 1:830 MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:WEST POINT
Practice Address - State:MS
Practice Address - Zip Code:39773-9319
Practice Address - Country:US
Practice Address - Phone:662-524-4386
Practice Address - Fax:662-391-2947
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-06
Last Update Date:2015-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS08934207R00000X, 207RH0005X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0005XAllopathic & Osteopathic PhysiciansInternal MedicineHypertension SpecialistGroup - Single Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
No207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS0017965Medicaid
MSB30267Medicare UPIN
MS110001132Medicare PIN