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Individual

DR. KIM LEON COX

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
777 HOSPITAL WAY, BLDG A SUITE 300, POCATELLO, ID 83201-5175
(208) 232-8792
(208) 232-8793
Mailing address
777 HOSPITAL WAY, BLDG A SUITE 300, POCATELLO, ID 83201-5175
(208) 232-8792
(208) 232-8793

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
M5779
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000010001682
REGENCE-BLUE SHIELD OF ID
ID
05
003643500
ID
01
160043915
RAILROAD MEDICARE
ID
01
76954
BLUE CROSS OF IDAHO
ID
Enumeration date
05/16/2006
Last updated
10/07/2011
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