MEDICARE: DOUGLAS STEWART FOX

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	2427	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1407096746
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DOUGLAS STEWART FOX

Provider Business Mailing Address
First Line	:	3305 VICTORIA CT
Second Line	:
City	:	JOHNSON CITY
State	:	TN
Zip	:	37604-2201
Country	:	US
Telephone Number	:	423-502-4158
Fax Number	:

Provider Business Practice Location Address
First Line	:	3305 VICTORIA CT
Second Line	:
City	:	JOHNSON CITY
State	:	TN
Zip	:	37604-2201
Country	:	US
Telephone Number	:	423-502-4158
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/26/2009
Last Update Date	:	01/19/2024

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Directions to “ DOUGLAS STEWART FOX ” Practice Location

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