MEDICARE: DR. MICHAEL A FOX MD

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
1	2085R0202X	Diagnostic Radiology Physician	29764	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1306812821
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL A FOX MD

Provider Business Mailing Address
First Line	:	209 S NEVADA AVE
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80903-1906
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2 S CASCADE AVE
Second Line	:	140
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80903-1624
Country	:	US
Telephone Number	:	719-538-2936
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/24/2006
Last Update Date	:	12/14/2021

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Directions to “ DR. MICHAEL A FOX MD” Practice Location

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