Provider Demographics
NPI:1578594958
Name:FOX, LANA G (MD)
Entity Type:Individual
Prefix:
First Name:LANA
Middle Name:G
Last Name:FOX
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:CEDAR CREEK PEDIATRIC & ADOLESCENT MEDICINE, PC
Mailing Address - Street 2:616 SMITVHIEW DRIVE
Mailing Address - City:MARYVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37803-6100
Mailing Address - Country:US
Mailing Address - Phone:865-379-2277
Mailing Address - Fax:865-738-0087
Practice Address - Street 1:CEDAR CREEK PEDIATRIC & ADOLESCENT MEDICINE, PC
Practice Address - Street 2:616 SMITVHIEW DRIVE
Practice Address - City:MARYVILLE
Practice Address - State:TN
Practice Address - Zip Code:37803-6100
Practice Address - Country:US
Practice Address - Phone:865-379-2277
Practice Address - Fax:865-738-0087
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2023-03-07
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Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TNMD29827208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN544-0501OtherBLUE CROSS ID #
TNMD29827OtherMEDICAL LICENSE
TNMD29827OtherMEDICAL LICENSE
TN544-0501OtherBLUE CROSS ID #