Healthcare Provider Details

I. General information

NPI: 1376750612
Provider Name (Legal Business Name): KERMIT W. FOX MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/17/2007
Last Update Date: 11/29/2022
Certification Date: 11/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2603 W MARKET ST STE 200
AKRON OH
44313-4234
US

IV. Provider business mailing address

2603 W MARKET ST STE 200
AKRON OH
44313-4234
US

V. Phone/Fax

Practice location:
  • Phone: 800-941-6672
  • Fax: 330-666-4394
Mailing address:
  • Phone: 800-941-6672
  • Fax: 330-666-4394

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number35.096221
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License NumberMD438381
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License NumberN2502
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: