Provider Demographics
NPI:1669766481
Name:FOX, SETH DAVID (DO)
Entity type:Individual
Prefix:DR
First Name:SETH
Middle Name:DAVID
Last Name:FOX
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:128 WEST 12 ST
Mailing Address - Street 2:STE 200
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16501
Mailing Address - Country:US
Mailing Address - Phone:814-452-2796
Mailing Address - Fax:814-454-7484
Practice Address - Street 1:128 WEST 12 ST
Practice Address - Street 2:STE 200
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16501
Practice Address - Country:US
Practice Address - Phone:814-452-2796
Practice Address - Fax:814-454-7484
Is Sole Proprietor?:No
Enumeration Date:2011-06-09
Last Update Date:2017-01-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAOS017528207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA103118277Medicaid
PA524299E67Medicare PIN