Provider Demographics
NPI:1932336609
Name:LORD, JANE COX (MD)
Entity Type:Individual
Prefix:DR
First Name:JANE
Middle Name:COX
Last Name:LORD
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 1:17327 BALLMONT PARK DR
Mailing Address - Street 2:
Mailing Address - City:ODESSA
Mailing Address - State:FL
Mailing Address - Zip Code:33556-6209
Mailing Address - Country:US
Mailing Address - Phone:813-928-7955
Mailing Address - Fax:
Practice Address - Street 1:17327 BALLMONT PARK DR
Practice Address - Street 2:
Practice Address - City:ODESSA
Practice Address - State:FL
Practice Address - Zip Code:33556-6209
Practice Address - Country:US
Practice Address - Phone:813-928-7955
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-19
Last Update Date:2009-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME53677207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine