Provider Demographics
NPI:1043445026
Name:FOX, KIMBERLY ANN (AUD, CCC-A)
Entity type:Individual
Prefix:DR
First Name:KIMBERLY
Middle Name:ANN
Last Name:FOX
Suffix:
Gender:F
Credentials:AUD, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3525 NW 56TH ST STE 150A
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-4548
Mailing Address - Country:US
Mailing Address - Phone:405-548-4300
Mailing Address - Fax:405-548-4350
Practice Address - Street 1:3525 NW 56TH ST
Practice Address - Street 2:STE 150A
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-4550
Practice Address - Country:US
Practice Address - Phone:405-548-4300
Practice Address - Fax:405-548-4350
Is Sole Proprietor?:No
Enumeration Date:2009-05-20
Last Update Date:2009-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK374237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK1215006150Medicaid
OK1215006150Medicaid