Provider Demographics
NPI:1417065285
Name:FOX, KENNETH L (DPM)
Entity Type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:L
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:PO BOX 9977
Mailing Address - Street 2:
Mailing Address - City:ST THOMAS
Mailing Address - State:VI
Mailing Address - Zip Code:00801-2977
Mailing Address - Country:US
Mailing Address - Phone:340-774-8819
Mailing Address - Fax:340-774-9051
Practice Address - Street 1:9149 SUGAR ESTATE STE. 308
Practice Address - Street 2:
Practice Address - City:ST THOMAS
Practice Address - State:VI
Practice Address - Zip Code:00802
Practice Address - Country:US
Practice Address - Phone:340-774-8819
Practice Address - Fax:340-774-9051
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-29
Last Update Date:2013-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VI404213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VIT36850Medicare UPIN
VI0048027Medicare ID - Type Unspecified