Provider Demographics
NPI:1528596699
Name:FOX, KACIE (MD)
Entity Type:Individual
Prefix:
First Name:KACIE
Middle Name:
Last Name:FOX
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1319 PUNAHOU ST STE 500
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96826-1072
Mailing Address - Country:US
Mailing Address - Phone:808-983-6905
Mailing Address - Fax:808-942-5748
Practice Address - Street 1:4210 WAIALAE AVE STE 501
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96816-5315
Practice Address - Country:US
Practice Address - Phone:808-462-5300
Practice Address - Fax:808-957-9775
Is Sole Proprietor?:No
Enumeration Date:2017-06-01
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI7273207V00000X
HI21858207V00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology