Provider Demographics
NPI:1669592846
Name:FOX, ANNA K (CO)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:K
Last Name:FOX
Suffix:
Gender:F
Credentials:CO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2571 PEMBROKE RD
Mailing Address - Street 2:
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28054-4712
Mailing Address - Country:US
Mailing Address - Phone:704-691-7145
Mailing Address - Fax:704-691-7631
Practice Address - Street 1:2571 PEMBROKE RD
Practice Address - Street 2:
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28054-4712
Practice Address - Country:US
Practice Address - Phone:704-691-7145
Practice Address - Fax:704-691-7631
Is Sole Proprietor?:No
Enumeration Date:2007-03-30
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7795025Medicaid