Provider Demographics
NPI:1881783678
Name:COX, ALFRED T (M D)
Entity type:Individual
Prefix:DR
First Name:ALFRED
Middle Name:T
Last Name:COX
Suffix:
Gender:M
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 218
Mailing Address - Street 2:
Mailing Address - City:CHELSEA
Mailing Address - State:OK
Mailing Address - Zip Code:74016-0218
Mailing Address - Country:US
Mailing Address - Phone:918-341-8100
Mailing Address - Fax:918-341-8139
Practice Address - Street 1:206 E BLUE STARR DR
Practice Address - Street 2:
Practice Address - City:CLAREMORE
Practice Address - State:OK
Practice Address - Zip Code:74017-4223
Practice Address - Country:US
Practice Address - Phone:918-341-8100
Practice Address - Fax:918-341-8139
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2016-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK14521207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200099660Medicaid
OKD38720Medicare UPIN