Burton Dale Cox Jr., DO

Individual provider Active NPI Family Medicine Physician · Boscobel, WI

NPI 1144382011 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1144382011
Entity type
Individual (NPI type 1)
Primary specialty
Family Medicine Physician 207Q00000X
License
33222-021 (WI)
Practice address
1101 Morrison Dr
Hsu
Boscobel, WI 53805-1180
Phone
(608) 375-6433
Fax
(608) 375-6439
NPI assigned
Dec 15, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
33222-021WIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Randolph Community Clinic SC Family Medicine Past
since Jan 1, 2001
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 33222-021 WI Yes

Addresses

Primary practice location

1101 Morrison Dr
Hsu
Boscobel, WI 53805-1180

Mailing address

1101 Morrison Dr
Hsu
Boscobel, WI 53805-1180
Phone (608) 375-6433

Other providers in Boscobel, WI

All providers in Boscobel, WI · Family Medicine Physician in Wisconsin

Sources for this page

Verify at the official NPI Registry.