Provider Demographics
NPI:1235135138
Name:FOX, EUGENE ARTHUR (DPM)
Entity Type:Individual
Prefix:
First Name:EUGENE
Middle Name:ARTHUR
Last Name:FOX
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4930 PALM AVE
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-3726
Mailing Address - Country:US
Mailing Address - Phone:305-887-1403
Mailing Address - Fax:305-887-0125
Practice Address - Street 1:4930 PALM AVE
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-3726
Practice Address - Country:US
Practice Address - Phone:305-887-1403
Practice Address - Fax:305-887-0125
Is Sole Proprietor?:No
Enumeration Date:2005-06-24
Last Update Date:2010-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO-0001582213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL029649000Medicaid
FL029649000Medicaid
FL87881Medicare ID - Type Unspecified