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General NPI Number Information
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NPI Number | 1992785836
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Entity Type | Individual
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Provider Name | ANGELA MARIE FOX-PUTNAM OD
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Gender | Female
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Dates
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Enumeration Date | 01/18/2006
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Last Update Date | 10/16/2024
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Provider Practice Location Address
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Address Line | 612 S MAIN ST
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City | MOUNT HOLLY
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State | NC
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Zip | 28120-1653
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Country | US
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Telephone | 704-822-0099
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Fax | 704-822-0077
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Provider Business Mailing Address
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Address Line | 612 SOUTH MAIN STREET
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City | MOUNT HOLLY
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State | NC
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Zip | 28120-1653
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Country | US
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Telephone | 704-822-0099
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Fax | 704-822-0077
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 1387
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License Number State | NC
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