Basic Information
| Provider Information | |||||||||
| NPI: | 1134539802 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | COX | ||||||||
| FirstName: | JAMES | ||||||||
| MiddleName: | ROBERT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 351 N. AIR DEPOT | ||||||||
| Address2: | STE. M | ||||||||
| City: | MIDWEST CITY | ||||||||
| State: | OK | ||||||||
| PostalCode: | 73110 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4056103644 | ||||||||
| FaxNumber: | 4056103647 | ||||||||
| Practice Location | |||||||||
| Address1: | 1429 N. MAIN | ||||||||
| Address2: | |||||||||
| City: | JAY | ||||||||
| State: | OK | ||||||||
| PostalCode: | 74346 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4056103644 | ||||||||
| FaxNumber: | 4056103647 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/05/2014 | ||||||||
| LastUpdateDate: | 05/05/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103K00000X | Y | Behavioral Health & Social Service Providers | Behavioral Analyst |
No ID Information.