Individual
DR. MATTHEW JOHN FOX
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9985 DAYTON LEBANON PIKE, CENTERVILLE, OH 45458
(937) 886-2980
(937) 886-2982
Mailing address
9985 DAYTON LEBANON PIKE, CENTERVILLE, OH 45458
(937) 886-2980
(937) 886-2982
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
35-06-8257-F
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2401681
—
OH
01
—
310961569-00
WORKERS COMP.
OH
01
—
310961569031
CARESOURCE
OH
01
—
D68257
HUMANA/CHOICE CARE
OH
Enumeration date
07/07/2006
Last updated
07/08/2007
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