Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207VE0102X | Reproductive Endocrinologist | 00023365 | AL |
N | 207VE0102X | Reproductive Endocrinologist | 049446 | GA |
Y | 207VE0102X | Reproductive Endocrinologist | ME66312 | FL |
NPI | 1508859646 |
---|---|
Provider Name | Michael Davis Fox |
First Address | Jacksonville, FL 32216-8709 |
Second Address | Jacksonville, FL 32216-8709 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/08/2005 |
Last Update Date | 31/03/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1716883001 | CIGNA (01) | |
2020611 | AETNA (01) | |
209420 | AVMED (01) | |
25315Z | BLUE SHIELD (01) | FL |
D80596 | (02) |