Provider Demographics
NPI: | 1346746914 |
---|---|
Name: | FOX, ROCKY (DO) |
Entity Type: | Individual |
Prefix: | DR |
First Name: | ROCKY |
Middle Name: | |
Last Name: | FOX |
Suffix: | |
Gender: | M |
Credentials: | DO |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | PULMONARY AND CRITICAL CARE MEDICINE FELLOWSHIP |
Mailing Address - Street 2: | 9300 CAMPUS POINT DRIVE, MAIL CODE 7381 |
Mailing Address - City: | LA JOLLA |
Mailing Address - State: | CA |
Mailing Address - Zip Code: | 92037 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 858-657-7118 |
Mailing Address - Fax: | |
Practice Address - Street 1: | SAN ANTONIO MILITARY MEDICAL CENTER, , MCHE-ZDM-M |
Practice Address - Street 2: | INTERNAL MEDICINE RESIDENCY, 3551 ROGER BROOKE DR. |
Practice Address - City: | JBSA-FORT SAM HOUSTON |
Practice Address - State: | TX |
Practice Address - Zip Code: | 78234-4504 |
Practice Address - Country: | US |
Practice Address - Phone: | 210-916-5910 |
Practice Address - Fax: | 210-916-2077 |
Is Sole Proprietor?: | Yes |
Enumeration Date: | 2018-04-03 |
Last Update Date: | 2021-07-09 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
390200000X | ||
VA | 0102205889 | 208D00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 208D00000X | Allopathic & Osteopathic Physicians | General Practice | |
No | 390200000X | Student, Health Care | Student in an Organized Health Care Education/Training Program |