Provider Demographics
NPI:1447783766
Name:FOX, ELIJAH (DO)
Entity type:Individual
Prefix:DR
First Name:ELIJAH
Middle Name:
Last Name:FOX
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40920 US HWY 280
Mailing Address - Street 2:
Mailing Address - City:SYLACAGUA
Mailing Address - State:AL
Mailing Address - Zip Code:35150
Mailing Address - Country:US
Mailing Address - Phone:205-678-1286
Mailing Address - Fax:205-618-9696
Practice Address - Street 1:309 GOVERNORS DRIVE SW
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801
Practice Address - Country:US
Practice Address - Phone:256-551-4579
Practice Address - Fax:256-551-4585
Is Sole Proprietor?:No
Enumeration Date:2017-04-04
Last Update Date:2022-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALDO.1935208000000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program