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NPI Code Detail

MEDICARE: JACOB FOX

MEDICARE:   JACOB  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
1152W00000XOptometristOEG003473PA

General Provider Information

NPI Number : 1689154528
Entity Type Code : Individual
Provider Name (Legal Business Name) : JACOB FOX
Provider Business Mailing Address
First Line : 1950 OLD GALLOWS RD
Second Line :
City : VIENNA
State : VA
Zip : 22182-3990
Country : US
Telephone Number : 703-847-8899
Fax Number :
Provider Business Practice Location Address
First Line : 2316 MEETINGHOUSE RD
Second Line :
City : UPPER CHICHESTER
State : PA
Zip : 19061-3438
Country : US
Telephone Number : 610-485-1500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/20/2018
Last Update Date : 11/03/2021

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Directions to “ JACOB FOX ” Practice Location

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