Provider Demographics
NPI:1437158961
Name:FOX, TIMOTHY ALAN (NP)
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:ALAN
Last Name:FOX
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 LOVELL ROAD
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37934-1904
Mailing Address - Country:US
Mailing Address - Phone:865-392-1400
Mailing Address - Fax:865-392-1402
Practice Address - Street 1:135 LOVELL ROAD
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37934-1904
Practice Address - Country:US
Practice Address - Phone:865-392-1500
Practice Address - Fax:865-392-1402
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-18
Last Update Date:2013-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN106268363L00000X
TNAPN0000007219363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
4121510OtherBLUE CROSS
TN3928997Medicaid
Q07151Medicare UPIN
3928997Medicare ID - Type Unspecified