Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NI0013X | Independent Medical Examiner | MO1579 | MO |
NPI | 1194920504 |
---|---|
Provider Name | Dr. Patrick Harmon Fox |
First Address | Manchester, MO 63021-5614 |
Second Address | Manchester, MO 63021-5495 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/06/2007 |
Last Update Date | 08/07/2007 |