Provider Demographics
NPI:1235153289
Name:FOX, CHRISTINA MARIE (OD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINA
Middle Name:MARIE
Last Name:FOX
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:236 S SANDUSKY AVE
Mailing Address - Street 2:
Mailing Address - City:BUCYRUS
Mailing Address - State:OH
Mailing Address - Zip Code:44820-2221
Mailing Address - Country:US
Mailing Address - Phone:419-562-0057
Mailing Address - Fax:419-562-0073
Practice Address - Street 1:236 S SANDUSKY AVE
Practice Address - Street 2:
Practice Address - City:BUCYRUS
Practice Address - State:OH
Practice Address - Zip Code:44820-2221
Practice Address - Country:US
Practice Address - Phone:419-562-0057
Practice Address - Fax:419-562-0073
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2010-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5307152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHP00056876OtherMEDICARE(RAILROAD)
OHEO14678OtherSPECTERA
OH2331953OtherUNITED HEALTH CARE
OH85394OtherCOLE VISION
OHOH5307OtherEYEMED
OH6421770001OtherDME
OH2400860OtherBUREAU CHILDREN W/HANDICA
OH2400860Medicaid
OH000000250503OtherANTHEM
OH0005482194OtherAETNA (GROUP)
OH0007867819OtherAETNA
OHEO14678OtherSPECTERA
OHOH5307OtherEYEMED