Provider Demographics
NPI:1922029719
Name:FOX, ALETA JEAN (PA)
Entity Type:Individual
Prefix:MS
First Name:ALETA
Middle Name:JEAN
Last Name:FOX
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Gender:F
Credentials:PA
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Mailing Address - Street 1:5300 N INDEPENDENCE AVE
Mailing Address - Street 2:280
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-5556
Mailing Address - Country:US
Mailing Address - Phone:918-540-7704
Mailing Address - Fax:918-540-7797
Practice Address - Street 1:310 2ND AVE SW
Practice Address - Street 2:STE. 107-B
Practice Address - City:MIAMI
Practice Address - State:OK
Practice Address - Zip Code:74354-6743
Practice Address - Country:US
Practice Address - Phone:918-540-7704
Practice Address - Fax:918-540-7797
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2018-02-22
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Provider Licenses
StateLicense IDTaxonomies
OK942363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100150140BMedicaid
OK200468380OMedicaid
OK100150140DMedicaid
OK100150140DMedicaid
OK100150140BMedicaid