MEDICARE: BRIAN W FOX PA-C

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	363A00000X	Physician Assistant	1835	CO
2	363A00000X	Physician Assistant	PA9114682	FL

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	:	1518028513
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRIAN W FOX PA-C

Provider Business Mailing Address
First Line	:	2270 SOMERSET PL
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34120-2862
Country	:	US
Telephone Number	:	303-931-7408
Fax Number	:

Provider Business Practice Location Address
First Line	:	1201 PIPER BLVD STE 24
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34110-1385
Country	:	US
Telephone Number	:	239-260-5307
Fax Number	:	239-260-5308

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

Provider Enumeration Date	:	12/13/2006
Last Update Date	:	07/12/2021

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Directions to “ BRIAN W FOX PA-C” Practice Location

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