Provider Demographics
NPI:1447662705
Name:FOX, JOHN M (DO)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:M
Last Name:FOX
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:435 PHALEN BLVD
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55130-5302
Mailing Address - Country:US
Mailing Address - Phone:651-636-9443
Mailing Address - Fax:651-265-7363
Practice Address - Street 1:435 PHALEN BLVD
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55130-5302
Practice Address - Country:US
Practice Address - Phone:651-636-9443
Practice Address - Fax:651-265-7363
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-21
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN685712081P0010X, 208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No2081P0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPediatric Rehabilitation Medicine