Basic Information
Provider Information
NPI: 1265437412
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: COX
FirstName: MARILYN
MiddleName: MARGARET
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1300 MEDICAL DR
Address2:  
City: TALLAHASSEE
State: FL
PostalCode: 323084646
CountryCode: US
TelephoneNumber: 8502160100
FaxNumber: 8502160138
Practice Location
Address1: 1300 MEDICAL DR
Address2:  
City: TALLAHASSEE
State: FL
PostalCode: 323084646
CountryCode: US
TelephoneNumber: 8502160100
FaxNumber: 8502160138
Other Information
ProviderEnumerationDate: 06/15/2005
LastUpdateDate: 07/09/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RC0001XME47541FLY Allopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology

ID Information
IDTypeStateIssuerDescription
0097901005AL MEDICAID
0128301FLUNIVERSAL HEALTH CAREOTHER
0262124505NY MEDICAID
1063901GABLUE CROSS/BLUE SHIELDOTHER
00730364A05GA MEDICAID
063344550005FL MEDICAID


Home