Provider Demographics
NPI:1871731984
Name:COXON, ADAM MARK (DC)
Entity type:Individual
Prefix:DR
First Name:ADAM
Middle Name:MARK
Last Name:COXON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1012 MARKET ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:FORT MILL
Mailing Address - State:SC
Mailing Address - Zip Code:29708-6461
Mailing Address - Country:US
Mailing Address - Phone:803-370-4294
Mailing Address - Fax:803-547-1896
Practice Address - Street 1:1012 MARKET ST
Practice Address - Street 2:SUITE 101
Practice Address - City:FORT MILL
Practice Address - State:SC
Practice Address - Zip Code:29708-6461
Practice Address - Country:US
Practice Address - Phone:803-370-3631
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-27
Last Update Date:2011-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3419111N00000X
NC3920111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor