Provider Demographics
NPI:1043269319
Name:FOX, JEFFREY P (RPH)
Entity Type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:P
Last Name:FOX
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:W148N7820 MENOMONEE MANOR DR
Mailing Address - Street 2:
Mailing Address - City:MENOMONEE FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:53051-4251
Mailing Address - Country:US
Mailing Address - Phone:262-250-0570
Mailing Address - Fax:
Practice Address - Street 1:W148N7820 MENOMONEE MANOR DR
Practice Address - Street 2:
Practice Address - City:MENOMONEE FALLS
Practice Address - State:WI
Practice Address - Zip Code:53051-4251
Practice Address - Country:US
Practice Address - Phone:262-250-0570
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI11339183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist