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NPI Code Detail

MEDICARE: MR. PETER R. FOX PA-C

MEDICARE: MR. PETER R. 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
1363A00000XPhysician AssistantPA00495OR

General Provider Information

NPI Number : 1902841745
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. PETER R. FOX PA-C
Provider Business Mailing Address
First Line : 199 W HIGHWAY 20
Second Line :
City : TOLEDO
State : OR
Zip : 97391-1242
Country : US
Telephone Number : 541-336-5181
Fax Number : 541-336-7614
Provider Business Practice Location Address
First Line : 199 W HIGHWAY 20
Second Line :
City : TOLEDO
State : OR
Zip : 97391-1242
Country : US
Telephone Number : 541-336-5181
Fax Number : 541-336-7614
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/17/2006
Last Update Date : 03/16/2017

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Directions to “ MR. PETER R. FOX PA-C” Practice Location

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