Provider Demographics
NPI:1083725527
Name:FOXX, KENNETH R (MD)
Entity Type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:R
Last Name:FOXX
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 25703
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23260-5703
Mailing Address - Country:US
Mailing Address - Phone:804-503-6879
Mailing Address - Fax:804-325-1425
Practice Address - Street 1:1109 W MARSHALL ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23220-3835
Practice Address - Country:US
Practice Address - Phone:804-503-6879
Practice Address - Fax:804-325-1425
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2010-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101240105208600000X
MDD64435208600000X
DCMD036178208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
C11045Medicare PIN