Provider Demographics
NPI:1972562783
Name:FOX, KEVIN (DC)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:
Last Name:FOX
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5656 S POWER RD
Mailing Address - Street 2:SUITE 132
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85295-8487
Mailing Address - Country:US
Mailing Address - Phone:480-985-0040
Mailing Address - Fax:480-279-5275
Practice Address - Street 1:5656 S POWER RD
Practice Address - Street 2:SUITE 132
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85295-8487
Practice Address - Country:US
Practice Address - Phone:480-985-0040
Practice Address - Fax:480-279-5275
Is Sole Proprietor?:No
Enumeration Date:2006-03-21
Last Update Date:2016-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5716111N00000X
AZAP42762081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
No111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZU68255Medicare UPIN
AZU68255Medicare UPIN