Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | 59.000375 | OH |
NPI | 1073898045 |
---|---|
Provider Name | Dr. Dustin Michael Fox |
First Address | Alliance, OH 44601-4936 |
Second Address | Alliance, OH 44601-4936 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/10/2011 |
Last Update Date | 20/10/2011 |