Organization
DR MARIE FOX PLC
Active
Other names
Kalamazoo Valley Eyecare
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARIE L FOX O.D. (OWNER/OPTOMETRIST)
(269) 375-3937
Entity
Organization
Contact information
Practice address
4855 W CENTRE AVE, SUITE B, PORTAGE, MI 49024-4686
(269) 375-3937
(269) 375-3938
Mailing address
4855 W CENTRE AVE, SUITE B, PORTAGE, MI 49024-4686
(269) 375-3937
(269) 375-3938
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901004197
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0C90369
BCBS PIN
MI
01
—
0C90390
BCBS PIN
MI
05
—
1568758209
—
MI
01
—
200000030622
PHP PROVIDER NUMBER
MI
Enumeration date
06/21/2011
Last updated
05/12/2012
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