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General NPI Number Information
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NPI Number | 1093989816
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Entity Type | Organization
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Legal Business Name | SANDRA K. FOX, DPM
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Dates
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Enumeration Date | 04/14/2008
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Last Update Date | 05/14/2008
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Provider Practice Location Address
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Address Line | 1063 N DETROIT ST
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City | XENIA
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State | OH
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Zip | 45385-1928
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Country | US
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Telephone | 937-376-2002
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Fax | 937-376-4042
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Provider Business Mailing Address
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Address Line | 1063 N DETROIT ST
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City | XENIA
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State | OH
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Zip | 45385-1928
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Country | US
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Telephone | 937-376-2002
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Fax | 937-376-4042
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Authorized Official
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Title or Position | D.P.M.
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Name | SANDRA K FOX
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Credential | OWNER
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Telephone | 937-376-2002
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0131X
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Taxonomy Name | Foot Surgery Podiatrist
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License Number | 36002599F
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License Number State | OH
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