Basic Information
Provider Information
NPI: 1366033599
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: COX
FirstName: CHRISTY
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 919 LAUREN COURT
Address2:  
City: SANDUSKY
State: OH
PostalCode: 44870
CountryCode: US
TelephoneNumber: 4193577356
FaxNumber:  
Practice Location
Address1: 1912 HAYES AVE
Address2:  
City: SANDUSKY
State: OH
PostalCode: 44870
CountryCode: US
TelephoneNumber: 4195022800
FaxNumber:  
Other Information
ProviderEnumerationDate: 01/31/2021
LastUpdateDate: 01/31/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 01/31/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2084P0800XRN270422OHY Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry

No ID Information.


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