Provider Demographics
NPI:1750355236
Name:FOX, MARK WARREN (MD)
Entity type:Individual
Prefix:
First Name:MARK
Middle Name:WARREN
Last Name:FOX
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 86370
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57118-6370
Mailing Address - Country:US
Mailing Address - Phone:605-322-7510
Mailing Address - Fax:605-322-6475
Practice Address - Street 1:1100 E 21ST ST
Practice Address - Street 2:STE 220
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57105-1020
Practice Address - Country:US
Practice Address - Phone:605-322-4825
Practice Address - Fax:605-322-4826
Is Sole Proprietor?:No
Enumeration Date:2006-02-14
Last Update Date:2009-01-15
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Provider Licenses
StateLicense IDTaxonomies
SD4319207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN320715300Medicaid
SD4319OtherDAKOTACARE
SD57105AU02OtherWPS TRICARE
MN63D16FOOtherCC SYSTEMS/BLUE PLUS FOR DATES PRIOR TO 9-1-07
SD1750355236OtherARAZ/ AMERICA'S PPO
SD0600325OtherMEDICA
SD231714OtherMIDLANDS CHOICE
MN46L94FOOtherCC SYSTEMS/BLUE PLUS
C83121001265OtherPREFERRED ONE
SD6100533Medicaid
NE10025562500Medicaid
SD4992870OtherBLUE CROSS
SDHP13310OtherHEALTHPARTNERS
MN46L94FOOtherCC SYSTEMS/BLUE PLUS
NE10025562500Medicaid