Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | 41653 | CO |
NPI | 1083696843 |
---|---|
Provider Name | Christopher R Fox |
First Address | Louisville, CO 80027-2453 |
Second Address | Louisville, CO 80027-2453 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/11/2005 |
Last Update Date | 10/07/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
32072775 | (05) | CO |
G89410 | (02) | CO |