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Individual

MS. JACLYN COX

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.O.

Contact information

Practice address
263 FARMINGTON AVE, FARMINGTON, CT 06030-0001
(860) 679-6296
Mailing address
263 FARMINGTON AVE, PROVIDER ENROLLMENT, FARMINGTON, CT 06030-2212
(860) 679-7503
(860) 679-1610

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
052037
CT
208M00000X
Hospitalist Physician
052037
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1891011250
CT
Enumeration date
04/09/2010
Last updated
09/29/2022
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