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General NPI Number Information
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NPI Number | 1447590070
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Entity Type | Organization
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Legal Business Name | FOX MEDICAL CLINIC
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Dates
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Enumeration Date | 02/19/2013
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Last Update Date | 02/19/2013
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Provider Practice Location Address
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Address Line | 135 LOVELL ROAD
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City | KNOXVILLE
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State | TN
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Zip | 37934-1904
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Country | US
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Telephone | 865-392-1400
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Fax | 865-392-1402
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Provider Business Mailing Address
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Address Line | 135 LOVELL ROAD
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City | KNOXVILLE
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State | TN
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Zip | 37934-1904
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Country | US
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Telephone | 865-392-1400
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Fax | 865-392-1402
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Authorized Official
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Title or Position | NURSE PRACTITIONER/OWNER
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Name | TIMOTHY ALAN FOX
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Credential | CFNP
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Telephone | 865-255-3921
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | APN0000007219
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License Number State | TN
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