Provider Demographics
NPI:1083657019
Name:FOX, RICHARD STUART JR (PA)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:STUART
Last Name:FOX
Suffix:JR
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:159 BLOSSOM RD
Mailing Address - Street 2:
Mailing Address - City:WESTPORT
Mailing Address - State:MA
Mailing Address - Zip Code:02790-3317
Mailing Address - Country:US
Mailing Address - Phone:508-971-9653
Mailing Address - Fax:
Practice Address - Street 1:277 PLEASANT ST STE 101
Practice Address - Street 2:
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02721-3005
Practice Address - Country:US
Practice Address - Phone:508-672-0545
Practice Address - Fax:508-672-0547
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2019-03-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA1216363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical