Provider Demographics
NPI:1811081904
Name:COX, MATTHEW NELSON (MD)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:NELSON
Last Name:COX
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2521 GRANITE CREST CIR
Mailing Address - Street 2:
Mailing Address - City:SANDY
Mailing Address - State:UT
Mailing Address - Zip Code:84092-7218
Mailing Address - Country:US
Mailing Address - Phone:801-943-4768
Mailing Address - Fax:
Practice Address - Street 1:1268 W SOUTH JORDAN PKWY
Practice Address - Street 2:STE 201
Practice Address - City:SOUTH JORDAN
Practice Address - State:UT
Practice Address - Zip Code:84095-4652
Practice Address - Country:US
Practice Address - Phone:801-254-9700
Practice Address - Fax:801-254-9755
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
UT359461-12052080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
UTH57875Medicare UPIN