MEDICARE: CONSTANCE FOX MD

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	2084P0800X	Psychiatry Physician	35038305F	OH

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
2	1321700	OTHER		UNITED MINE WORKERS
3	000000033604	OTHER	OH	ANTHEM
4	52266745400	OTHER	OH	BWC

General Provider Information

NPI Number	:	1417965435
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CONSTANCE FOX MD

Provider Business Mailing Address
First Line	:	58 EAST HOLLISTER STREET
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45219-1704
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	58 EAST HOLLISTER STREET
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45219-1704
Country	:	US
Telephone Number	:	513-721-1737
Fax Number	:	513-287-7465

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

Provider Enumeration Date	:	08/04/2006
Last Update Date	:	07/08/2007

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Directions to “ CONSTANCE FOX MD” Practice Location

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