Provider Demographics
NPI:1538214614
Name:COX, KEVIN KEITH (MD)
Entity type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:KEITH
Last Name:COX
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1182 MARIANO DR
Mailing Address - Street 2:
Mailing Address - City:OJAI
Mailing Address - State:CA
Mailing Address - Zip Code:93023-3450
Mailing Address - Country:US
Mailing Address - Phone:805-646-6980
Mailing Address - Fax:805-646-8419
Practice Address - Street 1:1182 MARIANO DR
Practice Address - Street 2:
Practice Address - City:OJAI
Practice Address - State:CA
Practice Address - Zip Code:93023-3450
Practice Address - Country:US
Practice Address - Phone:805-646-6980
Practice Address - Fax:805-646-8419
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG0583732084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAE50250Medicare UPIN