Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | 220532 | MA |
NPI | 1487688149 |
---|---|
Provider Name | Albert J Fox |
First Address | Fairhaven, MA 02719-5255 |
Second Address | N Dartmouth, MA 02747-6244 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/07/2006 |
Last Update Date | 21/04/2020 |