Individual
MARK DOUGLAS FOX
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1234 N NOTRE DAME AVE, SOUTH BEND, IN 46617-1404
(574) 631-1337
(574) 631-8932
Mailing address
1234 N NOTRE DAME AVE, SOUTH BEND, IN 46617-1404
(574) 631-1337
(574) 631-8932
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01075847A
IN
207R00000X
Internal Medicine Physician
23209
OK
208000000X
Pediatrics Physician
01075847A
IN
208000000X
Pediatrics Physician
23209
OK
2083P0901X
Public Health & General Preventive Medicine Physician
Primary
01075847A
IN
Other
Enumeration date
01/26/2006
Last updated
10/21/2019
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