Provider Demographics
NPI:1386643302
Name:FOX, JAMES MICHAEL (DC)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:MICHAEL
Last Name:FOX
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1809 W COX RD
Mailing Address - Street 2:P.O. BOX 127
Mailing Address - City:EDGERTON
Mailing Address - State:WI
Mailing Address - Zip Code:53534-8525
Mailing Address - Country:US
Mailing Address - Phone:608-754-3977
Mailing Address - Fax:608-868-6566
Practice Address - Street 1:1809 W COX RD
Practice Address - Street 2:BOX 127
Practice Address - City:EDGERTON
Practice Address - State:WI
Practice Address - Zip Code:53534-8525
Practice Address - Country:US
Practice Address - Phone:608-754-3977
Practice Address - Fax:608-868-6566
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3264111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WIU57048Medicare UPIN