Basic Information
Provider Information
NPI: 1831219468
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: COX
FirstName: CHARLOTTE
MiddleName: W
NamePrefix: MS.
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 9054
Address2:  
City: GRAY
State: TN
PostalCode: 376159054
CountryCode: US
TelephoneNumber: 4234673600
FaxNumber: 4234673644
Practice Location
Address1: 36 KING ST
Address2:  
City: BRISTOL
State: VA
PostalCode: 242014134
CountryCode: US
TelephoneNumber: 2764662286
FaxNumber: 2764662286
Other Information
ProviderEnumerationDate: 03/29/2007
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
247200000X  Y Technologists, Technicians & Other Technical Service ProvidersTechnician, Other 

No ID Information.


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