Provider Demographics
NPI:1265515514
Name:FOX, JOEL E (DC)
Entity type:Individual
Prefix:DR
First Name:JOEL
Middle Name:E
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:PO BOX 72344
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30007-2344
Mailing Address - Country:US
Mailing Address - Phone:770-924-9400
Mailing Address - Fax:770-924-3100
Practice Address - Street 1:715A BASCOMB COMMERCIAL PKWY
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:GA
Practice Address - Zip Code:30189-2466
Practice Address - Country:US
Practice Address - Phone:770-924-9400
Practice Address - Fax:770-924-3100
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-23
Last Update Date:2012-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA5682111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA582524493OtherTAX ID #
GAU81157Medicare UPIN
GA35ZCGBRMedicare ID - Type UnspecifiedMEDICARE #