Individual
JONATHAN RAPHAEL FOX
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1970 E 3RD AVE STE 1, DURANGO, CO 81301-5049
(970) 444-0260
Mailing address
PO BOX 844088, DALLAS, TX 75284-4088
(505) 609-2258
(505) 609-2259
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
883
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07008832
—
CO
05
—
S4634
—
NM
Enumeration date
08/31/2006
Last updated
08/26/2025
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