Provider Demographics
NPI:1740676089
Name:FOX, JENNIFER MARIE (CSFA)
Entity type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:MARIE
Last Name:FOX
Suffix:
Gender:F
Credentials:CSFA
Other - Prefix:MS
Other - First Name:JENNIFER
Other - Middle Name:MARIE
Other - Last Name:FOX
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CSFA
Mailing Address - Street 1:5353 REYNOLDS ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31405-6015
Mailing Address - Country:US
Mailing Address - Phone:912-819-5771
Mailing Address - Fax:912-819-5772
Practice Address - Street 1:5353 REYNOLDS ST
Practice Address - Street 2:SUITE 200
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405-6015
Practice Address - Country:US
Practice Address - Phone:912-819-5771
Practice Address - Fax:912-819-5772
Is Sole Proprietor?:No
Enumeration Date:2015-04-14
Last Update Date:2015-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant