Provider Demographics
NPI:1205827953
Name:FOX, JOHN MICHAEL (DC)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:MICHAEL
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 1:423 S RIVERSIDE DR
Mailing Address - Street 2:STE A1
Mailing Address - City:ESPANOLA
Mailing Address - State:NM
Mailing Address - Zip Code:87532-2980
Mailing Address - Country:US
Mailing Address - Phone:505-753-3001
Mailing Address - Fax:505-753-3052
Practice Address - Street 1:8801 BUCCOLA AVE
Practice Address - Street 2:STE 600
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79119-6793
Practice Address - Country:US
Practice Address - Phone:806-477-9463
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-02
Last Update Date:2022-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14839111N00000X
NM1497111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor