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NPI Code Detail

MEDICARE: MARIE ELIZABETH FOX LDH

MEDICARE: MARIE ELIZABETH FOX LDH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1124Q00000XDental Hygienist13005662AIN

General Provider Information

NPI Number : 1275613911
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARIE ELIZABETH FOX LDH
Provider Business Mailing Address
First Line : 2926 S IRWIN ST
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46203-5813
Country : US
Telephone Number : 317-357-1402
Fax Number : 317-890-2135
Provider Business Practice Location Address
First Line : 9443 E 38TH ST
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46235-2132
Country : US
Telephone Number : 317-890-2131
Fax Number : 317-890-2135
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/17/2006
Last Update Date : 07/08/2007

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Directions to “ MARIE ELIZABETH FOX LDH” Practice Location

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