Basic Information
Provider Information
NPI: 1912399726
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: COX
FirstName: DAWN
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
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OtherLastName:  
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Mailing Information
Address1: 550 PEACHTREE ST NE
Address2:  
City: ATLANTA
State: GA
PostalCode: 303082208
CountryCode: US
TelephoneNumber: 4046867858
FaxNumber: 4046867841
Practice Location
Address1: 460 NORTHSIDE CHEROKEE BLVD STE 130
Address2:  
City: CANTON
State: GA
PostalCode: 301158017
CountryCode: US
TelephoneNumber: 6784932527
FaxNumber: 6784935608
Other Information
ProviderEnumerationDate: 03/03/2015
LastUpdateDate: 02/26/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 02/26/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163WC0200XRN147950GAN Nursing Service ProvidersRegistered NurseCritical Care Medicine
363LC0200XRN147350GAY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCritical Care Medicine

No ID Information.


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