Individual
DR. JOHN ROBERT FOX
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
325 SOUTH CEDAR AVENUE, SUITE 1, SOUTH PITTSBURG, TN 37380-1305
(423) 228-4159
Mailing address
325 SOUTH CEDAR AVENUE, SUITE 1, SOUTH PITTSBURG, TN 37380-1305
(423) 228-4159
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
31310
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1504527
—
TN
01
—
4076373
BCBS PROVIDER NUMBER
TN
01
—
TN0101
UNITED HEALTHCARE OF RIVER VALLEY PROVIDER NUMBER
TN
Enumeration date
09/13/2006
Last updated
09/17/2008
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