Provider Demographics
NPI:1831251461
Name:FOX, BRANDON MALONE (HEALTH SERVICE TECHN)
Entity type:Individual
Prefix:MR
First Name:BRANDON
Middle Name:MALONE
Last Name:FOX
Suffix:
Gender:M
Credentials:HEALTH SERVICE TECHN
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 25517
Mailing Address - Street 2:
Mailing Address - City:JUNEAU
Mailing Address - State:AK
Mailing Address - Zip Code:99802-5517
Mailing Address - Country:US
Mailing Address - Phone:907-463-2152
Mailing Address - Fax:
Practice Address - Street 1:907 W. 9TH ST.
Practice Address - Street 2:
Practice Address - City:JUNEAU
Practice Address - State:AK
Practice Address - Zip Code:99801
Practice Address - Country:US
Practice Address - Phone:907-463-2152
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other