Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 142100 | AK |
Y | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | 142100 | AK |
NPI | 1093057895 |
---|---|
Provider Name | Rabun Samuel Fox |
First Address | New Orleans, LA 70124-0702 |
Second Address | Anchorage, AK 99508-4680 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/03/2013 |
Last Update Date | 12/09/2019 |