Provider Demographics
NPI:1952589897
Name:COX, DEITRICK L (MD)
Entity Type:Individual
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First Name:DEITRICK
Middle Name:L
Last Name:COX
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Gender:M
Credentials:MD
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Mailing Address - Street 1:900 CIRCLE 75 PKWY SE
Mailing Address - Street 2:STE 1700
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30339-3087
Mailing Address - Country:US
Mailing Address - Phone:770-953-6929
Mailing Address - Fax:770-953-6972
Practice Address - Street 1:3672 MARATHON CIR STE 200
Practice Address - Street 2:
Practice Address - City:AUSTELL
Practice Address - State:GA
Practice Address - Zip Code:30106-6821
Practice Address - Country:US
Practice Address - Phone:770-944-3303
Practice Address - Fax:770-944-0285
Is Sole Proprietor?:No
Enumeration Date:2008-02-01
Last Update Date:2017-02-10
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Provider Licenses
StateLicense IDTaxonomies
GA06539208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation