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NPI Code Detail

MEDICARE: MR. JUSTIN FOX

MEDICARE: MR. JUSTIN 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
1183500000XPharmacist019448LA

General Provider Information

NPI Number : 1720360662
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JUSTIN FOX
Provider Business Mailing Address
First Line : 7444 MEADOW PARK AVE
Second Line :
City : BATON ROUGE
State : LA
Zip : 70810-2009
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2520 PLANK RD
Second Line :
City : BATON ROUGE
State : LA
Zip : 70805-8027
Country : US
Telephone Number : 225-357-1484
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/16/2011
Last Update Date : 09/16/2011

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Directions to “ MR. JUSTIN FOX ” Practice Location

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