Provider Demographics
NPI:1841310497
Name:COX, WALTER GREGORY (PHD)
Entity type:Individual
Prefix:DR
First Name:WALTER
Middle Name:GREGORY
Last Name:COX
Suffix:
Gender:M
Credentials:PHD
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Mailing Address - Street 1:2923 PLAYER ST
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:GA
Mailing Address - Zip Code:31520-4950
Mailing Address - Country:US
Mailing Address - Phone:770-363-6378
Mailing Address - Fax:912-264-1096
Practice Address - Street 1:2130 SW JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97201-7709
Practice Address - Country:US
Practice Address - Phone:770-363-6378
Practice Address - Fax:912-264-1096
Is Sole Proprietor?:No
Enumeration Date:2007-03-29
Last Update Date:2022-12-07
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA328437173BMedicaid
GA1362OtherPSYCHOLOGY