Provider Demographics
NPI:1447267059
Name:FOX, DAVID GERARD (LISW)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:GERARD
Last Name:FOX
Suffix:
Gender:M
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:403 1ST ST SE
Mailing Address - Street 2:
Mailing Address - City:BELMOND
Mailing Address - State:IA
Mailing Address - Zip Code:50421-1201
Mailing Address - Country:US
Mailing Address - Phone:641-444-3500
Mailing Address - Fax:641-444-5554
Practice Address - Street 1:403 1ST ST SE
Practice Address - Street 2:
Practice Address - City:BELMOND
Practice Address - State:IA
Practice Address - Zip Code:50421-1201
Practice Address - Country:US
Practice Address - Phone:641-444-3500
Practice Address - Fax:641-444-5554
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2018-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA00084104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker