Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | 6312 | NH |
NPI | 1134403736 |
---|---|
Provider Name | Dr. Richard A Fox |
First Address | Windham, NH 03087-1614 |
Second Address | Windham, NH 03087-1614 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/10/2011 |
Last Update Date | 01/10/2011 |