Provider Demographics
NPI:1134879646
Name:COX, AUSTEN (DO)
Entity type:Individual
Prefix:
First Name:AUSTEN
Middle Name:
Last Name:COX
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6377 S EDEN LAKE RD
Mailing Address - Street 2:
Mailing Address - City:CUSTER
Mailing Address - State:MI
Mailing Address - Zip Code:49405-9654
Mailing Address - Country:US
Mailing Address - Phone:231-233-8530
Mailing Address - Fax:
Practice Address - Street 1:1675 LEAHY ST STE 201
Practice Address - Street 2:
Practice Address - City:MUSKEGON
Practice Address - State:MI
Practice Address - Zip Code:49442-5542
Practice Address - Country:US
Practice Address - Phone:231-740-6180
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-27
Last Update Date:2022-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program