Provider Demographics
NPI:1093739864
Name:FOX, CHAD BYRON (AUD)
Entity Type:Individual
Prefix:DR
First Name:CHAD
Middle Name:BYRON
Last Name:FOX
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 PROFESSIONAL AVE
Mailing Address - Street 2:
Mailing Address - City:WEST COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29169-4711
Mailing Address - Country:US
Mailing Address - Phone:803-926-2220
Mailing Address - Fax:803-926-2220
Practice Address - Street 1:103 PROFESSIONAL AVE
Practice Address - Street 2:
Practice Address - City:WEST COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29169-4711
Practice Address - Country:US
Practice Address - Phone:803-926-2220
Practice Address - Fax:803-926-2220
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2932231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCQ20935Medicare UPIN