Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207XP3100X | Pediatric Orthopaedic Surgeon | 60858528 | WA |
Y | 207XP3100X | Pediatric Orthopaedic Surgeon | 78179 | MT |
NPI | 1164867370 |
---|---|
Provider Name | Joseph Fox |
First Address | Seattle, WA 98105-3901 |
Second Address | Missoula, MT 59804-7424 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/05/2013 |
Last Update Date | 28/07/2020 |