Provider Demographics
NPI:1467439620
Name:FOX, MARLON KEITH (DC)
Entity Type:Individual
Prefix:DR
First Name:MARLON
Middle Name:KEITH
Last Name:FOX
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7944 DORCHESTER RD
Mailing Address - Street 2:SUITE 3
Mailing Address - City:NORTH CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29418-2919
Mailing Address - Country:US
Mailing Address - Phone:843-552-0000
Mailing Address - Fax:843-552-0010
Practice Address - Street 1:7944 DORCHESTER RD
Practice Address - Street 2:SUITE 3
Practice Address - City:NORTH CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29418-2919
Practice Address - Country:US
Practice Address - Phone:843-552-0000
Practice Address - Fax:843-552-0231
Is Sole Proprietor?:No
Enumeration Date:2005-12-29
Last Update Date:2008-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1256111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCT248300281Medicare ID - Type Unspecified