Individual
KENNETH A. FOX
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1501 N CAMPBELL AVE, TUCSON, AZ 85724
(520) 626-9752
Mailing address
1501 N CAMPBELL AVE, TUCSON, AZ 85724-0001
(520) 626-9752
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
G154681
CA
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
L2253
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
146137801
—
TX
01
—
741794684
TAX ID NO
TX
01
—
89454S
BCBS PROV NO
TX
Enumeration date
07/27/2006
Last updated
03/05/2020
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