Provider Demographics
NPI:1558399717
Name:FOX, DEBORAH C (DO)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:C
Last Name:FOX
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P. O. BOX 8500 - 6335
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19178-0001
Mailing Address - Country:US
Mailing Address - Phone:215-807-8000
Mailing Address - Fax:215-807-8235
Practice Address - Street 1:1627 CHEW ST
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18102-3648
Practice Address - Country:US
Practice Address - Phone:610-969-3390
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS009973L207Q00000X, 207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0017355190005Medicaid
PA0017355190006Medicaid
PA00175355190007Medicaid
PA2063963OtherUNITED HEALTHCARE
PA0735768000OtherKEYSTONE, IBC
PA2365272OtherAETNA HMO
PA30010987OtherKEYSTONE MERCY
PAP00296387OtherRAILROAD MEDICARE
PA0017355190004Medicaid
PA01735519-07OtherAMERICHOICE
PA977185OtherHIGHMARK BLUE SHIELD
PA7345111OtherAETNA PPO
PA977185OtherPERSONAL CHOICE
PA35651OtherHEALTH PARTNERS
PA2365272OtherAETNA HMO
PA00175355190007Medicaid