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General NPI Number Information
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NPI Number | 1083989057
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Entity Type | Organization
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Legal Business Name | ALBERT FOX FACIAL PLASTIC SURGERY CENTER
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Dates
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Enumeration Date | 03/09/2012
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Last Update Date | 03/09/2012
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Provider Practice Location Address
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Address Line | 299 FAUNCE CORNER RD
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City | N DARTMOUTH
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State | MA
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Zip | 02747-1218
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Country | US
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Telephone | 508-207-4455
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Fax | 508-207-4474
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Provider Business Mailing Address
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Address Line | 299 FAUNCE CORNER RD
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City | N DARTMOUTH
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State | MA
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Zip | 02747-1218
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Country | US
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Telephone | 508-207-4455
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Fax | 508-207-4474
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Authorized Official
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Title or Position | OWNER/MD
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Name | ALBERT J FOX
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Credential | M.D.
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Telephone | 508-207-4455
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | 220532
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License Number State | MA
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