MEDICARE: SUSAN J 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	2083P0500X	Preventive Medicine/Occupational Environmental Medicine Physician	59011	CO

General Provider Information

NPI Number	:	1881733285
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUSAN J FOX

Provider Business Mailing Address
First Line	:	13990 E CHENANGO DR
Second Line	:
City	:	AURORA
State	:	CO
Zip	:	80015-3906
Country	:	US
Telephone Number	:	720-870-6947
Fax Number	:

Provider Business Practice Location Address
First Line	:	10065 E HARVARD AVE STE 250
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80231-5968
Country	:	US
Telephone Number	:	303-614-1052
Fax Number	:

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

Provider Enumeration Date	:	02/05/2007
Last Update Date	:	10/30/2007

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