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Individual
KYLE FOX
Active
Individual
KYLE FOX
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-07005
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0397730038
NSC #
NC
Enumeration date
01/25/2017
Last updated
06/06/2019
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