Provider Demographics
NPI:1144261694
Name:COX, KAREN FORTE (PA-C)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:FORTE
Last Name:COX
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:RENEE
Other - Last Name:FORTE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:3153 DAUPHIN ST
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36606-4061
Mailing Address - Country:US
Mailing Address - Phone:251-435-4961
Mailing Address - Fax:251-435-7839
Practice Address - Street 1:3153 DAUPHIN ST
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36606-4061
Practice Address - Country:US
Practice Address - Phone:251-435-4961
Practice Address - Fax:251-435-7839
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPA 436363AM0700X
ALPA.436363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051531979Medicaid
AL515-31979OtherBLUE CROSS BLUE SHIELD
AL051531979Medicaid
ALQ61480Medicare UPIN