Provider Demographics
NPI:1164474086
Name:FOX, JOHN G (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:G
Last Name:FOX
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1007 JEFFORDS ST STE 101
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33756-4082
Mailing Address - Country:US
Mailing Address - Phone:727-444-0407
Mailing Address - Fax:727-223-5270
Practice Address - Street 1:1007 JEFFORDS ST STE 101
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33756-4082
Practice Address - Country:US
Practice Address - Phone:727-443-1122
Practice Address - Fax:727-223-5270
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2022-07-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME73336207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL110219951OtherRAILROAD MEDICARE
FL262723000Medicaid
FL262723000Medicaid
FL41458YMedicare PIN