Provider Demographics
NPI:1659371730
Name:FOX, STEPHEN P (MD)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:P
Last Name:FOX
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Gender:M
Credentials:MD
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Mailing Address - Street 1:2600 RIB MOUNTAIN DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:WAUSAU
Mailing Address - State:WI
Mailing Address - Zip Code:54401-7196
Mailing Address - Country:US
Mailing Address - Phone:715-870-2162
Mailing Address - Fax:715-870-2163
Practice Address - Street 1:2600 RIB MOUNTAIN DR STE 200
Practice Address - Street 2:SUITE 200
Practice Address - City:WAUSAU
Practice Address - State:WI
Practice Address - Zip Code:54401-7196
Practice Address - Country:US
Practice Address - Phone:715-870-2162
Practice Address - Fax:715-870-2163
Is Sole Proprietor?:No
Enumeration Date:2005-07-29
Last Update Date:2016-11-22
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Provider Licenses
StateLicense IDTaxonomies
WI37354208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI32183400Medicaid
F31939Medicare UPIN
WI32183400Medicaid