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General NPI Number Information
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NPI Number | 1518279827
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Entity Type | Individual
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Provider Name | KELITA L FOX MD
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Gender | Female
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Dates
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Enumeration Date | 07/02/2010
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Last Update Date | 06/15/2020
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Provider Practice Location Address
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Address Line | 158 ORCHARD ST
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City | ROCHESTER
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State | NY
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Zip | 14611-1361
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Country | US
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Telephone | 585-368-4500
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Fax | 585-436-6047
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Provider Business Mailing Address
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Address Line | 158 ORCHARD ST
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City | ROCHESTER
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State | NY
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Zip | 14611-1361
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Country | US
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Telephone | 585-368-4500
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Fax | 585-436-6047
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 4301501395
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 269938
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License Number State | NY
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