Provider Demographics
NPI:1467262352
Name:FOX, ROBERT LEWIS
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:LEWIS
Last Name:FOX
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9051 EXECUTIVE PARK DR STE 600
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37923-4633
Mailing Address - Country:US
Mailing Address - Phone:865-474-0074
Mailing Address - Fax:
Practice Address - Street 1:9051 EXECUTIVE PARK DR STE 600
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37923-4633
Practice Address - Country:US
Practice Address - Phone:865-474-0074
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-13
Last Update Date:2025-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN9341225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty