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General NPI Number Information
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NPI Number | 1134511652
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Entity Type | Organization
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Legal Business Name | LOURDES MEDICAL ASSOCIATES, PA
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Dates
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Enumeration Date | 02/20/2015
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Last Update Date | 02/20/2015
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Provider Practice Location Address
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Address Line | 300 CREEK CROSSING BLVD
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City | HAINESPORT
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State | NJ
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Zip | 08036-2767
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Country | US
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Telephone | 609-702-0014
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Fax | 609-702-7225
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Provider Business Mailing Address
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Address Line | 500 GROVE ST SUITE 100
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City | HADDON HEIGHTS
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State | NJ
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Zip | 08035-1761
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Country | US
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Telephone | 856-796-9200
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Fax | 856-796-9397
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. STEVEN FOX
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Credential | MD
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Telephone | 856-796-9200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State | NJ
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