Provider Demographics
NPI:1780035485
Name:FOX, ABIGAIL (RD)
Entity Type:Individual
Prefix:MS
First Name:ABIGAIL
Middle Name:
Last Name:FOX
Suffix:
Gender:F
Credentials:RD
Other - Prefix:MRS
Other - First Name:ABIGAIL
Other - Middle Name:F
Other - Last Name:HARRIS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RD
Mailing Address - Street 1:55 MIDTOWN PARK E
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36606-4141
Mailing Address - Country:US
Mailing Address - Phone:251-478-2233
Mailing Address - Fax:251-478-2231
Practice Address - Street 1:55 MIDTOWN PARK E
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36606-4141
Practice Address - Country:US
Practice Address - Phone:251-478-2233
Practice Address - Fax:251-478-2231
Is Sole Proprietor?:No
Enumeration Date:2016-06-24
Last Update Date:2016-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2590133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered