Basic Information
| Provider Information | |||||||||
| NPI: | 1770815938 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | COX REGIONAL SERVICES | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | COXHEALTH GYNECOLOGY CLINIC OF MONETT | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 4046 | ||||||||
| Address2: | |||||||||
| City: | SPRINGFIELD | ||||||||
| State: | MO | ||||||||
| PostalCode: | 658084046 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4172695712 | ||||||||
| FaxNumber: | 4172694869 | ||||||||
| Practice Location | |||||||||
| Address1: | 815 N LINCOLN AVE | ||||||||
| Address2: | STE D | ||||||||
| City: | MONETT | ||||||||
| State: | MO | ||||||||
| PostalCode: | 657081641 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4172362475 | ||||||||
| FaxNumber: | 4173541458 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/12/2010 | ||||||||
| LastUpdateDate: | 02/12/2010 | ||||||||
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| AuthorizedOfficialLastName: | TAYLOR | ||||||||
| AuthorizedOfficialFirstName: | DAVID | ||||||||
| AuthorizedOfficialMiddleName: | P | ||||||||
| AuthorizedOfficialTitleorPosition: | V.P. REGIONAL SERVICES | ||||||||
| AuthorizedOfficialTelephone: | 4172694320 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | LESTER E COX MEDICAL CENTERS | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207VG0400X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Gynecology |
No ID Information.