=====================================================
General NPI Number Information
=====================================================
NPI Number | 1023329372
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | LATEYA C FOXX D.O.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/01/2010
-----------------------------------------------------
Last Update Date | 11/17/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 14540 OLD SAINT AUGUSTINE RD STE 2207
-----------------------------------------------------
City | JACKSONVILLE
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32258-7419
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 904-224-8090
-----------------------------------------------------
Fax | 904-391-5507
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 746649
-----------------------------------------------------
City | ATLANTA
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30374-6649
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 904-202-2092
-----------------------------------------------------
Fax | 904-376-4075
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2084N0400X
-----------------------------------------------------
Taxonomy Name | Neurology Physician
-----------------------------------------------------
License Number | E-20059
-----------------------------------------------------
License Number State | AR
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 2084N0400X
-----------------------------------------------------
Taxonomy Name | Neurology Physician
-----------------------------------------------------
License Number | OS12511
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------