Provider Demographics
NPI:1114957537
Name:FOX, JOHN LEROY (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:LEROY
Last Name:FOX
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:5400 B ST
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-3404
Mailing Address - Country:US
Mailing Address - Phone:501-664-7748
Mailing Address - Fax:501-664-7748
Practice Address - Street 1:5400 B ST
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-3404
Practice Address - Country:US
Practice Address - Phone:501-664-7748
Practice Address - Fax:501-664-7748
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-1076207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
ARB68061Medicare UPIN
AR96728FOMedicare ID - Type Unspecified