Provider Demographics
NPI:1710956362
Name:FOX, BRIAN (MD)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:
Last Name:FOX
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1995 ERRECART BLVD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:ELKO
Mailing Address - State:NV
Mailing Address - Zip Code:89801-8334
Mailing Address - Country:US
Mailing Address - Phone:775-777-1600
Mailing Address - Fax:775-777-1700
Practice Address - Street 1:1995 ERRECART BLVD
Practice Address - Street 2:SUITE 103
Practice Address - City:ELKO
Practice Address - State:NV
Practice Address - Zip Code:89801-8334
Practice Address - Country:US
Practice Address - Phone:775-777-1600
Practice Address - Fax:775-777-1700
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV10041207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
B52869Medicare UPIN