Individual
KEVIN L FOX
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
600 W RIDGE RD, WYTHEVILLE, VA 24382-1044
(227) 662-5882
Mailing address
130 NOTTINGHAM DR, WYTHEVILLE, VA 24382-1412
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
0101236457
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010261082
—
VA
01
—
P00314754
MEDICARE RAILROAD
VA
Enumeration date
06/08/2006
Last updated
12/04/2007
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