Provider Demographics
NPI:1629036488
Name:FOX, LEVERNE SMITH JR (MD)
Entity Type:Individual
Prefix:
First Name:LEVERNE
Middle Name:SMITH
Last Name:FOX
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1771 TATE BLVD SE STE 201
Mailing Address - Street 2:
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28602-4250
Mailing Address - Country:US
Mailing Address - Phone:828-324-4804
Mailing Address - Fax:828-324-7256
Practice Address - Street 1:178 HIGHWAY 105 EXT STE 102
Practice Address - Street 2:
Practice Address - City:BOONE
Practice Address - State:NC
Practice Address - Zip Code:28607-5667
Practice Address - Country:US
Practice Address - Phone:828-262-0140
Practice Address - Fax:828-262-0160
Is Sole Proprietor?:No
Enumeration Date:2006-05-02
Last Update Date:2023-12-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SC12776207RC0000X
NC25286207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC14584OtherBCBS
SC127767Medicaid
NC890526NMedicaid
NC2069908Medicare PIN
D17690Medicare UPIN