Provider Demographics
NPI:1912954397
Name:COX, LINDA (MD)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:
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 1:30840 NORTHWESTERN HWY
Mailing Address - Street 2:SUITE 110
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334-2552
Mailing Address - Country:US
Mailing Address - Phone:248-626-0199
Mailing Address - Fax:248-626-9698
Practice Address - Street 1:30840 NORTHWESTERN HWY
Practice Address - Street 2:SUITE 110
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-2552
Practice Address - Country:US
Practice Address - Phone:248-626-0199
Practice Address - Fax:248-626-9698
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MILC066993208D00000X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Not Answered207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI080F32080OtherBC # FMC
MI080F32080OtherBC # FMC