Provider Demographics
NPI:1952433641
Name:FOX, MONIQUE E (MD)
Entity Type:Individual
Prefix:DR
First Name:MONIQUE
Middle Name:E
Last Name:FOX
Suffix:
Gender:F
Credentials:MD
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 800022
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64180-0022
Mailing Address - Country:US
Mailing Address - Phone:800-953-0104
Mailing Address - Fax:303-765-6670
Practice Address - Street 1:11700 W 2ND PL STE 100
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80228-1707
Practice Address - Country:US
Practice Address - Phone:720-321-8230
Practice Address - Fax:720-321-8231
Is Sole Proprietor?:No
Enumeration Date:2007-03-09
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO459672085R0202X, 2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036110599OtherLICENSE
CO73806803Medicaid
COC809762Medicare PIN
COC809763Medicare PIN
IL036110599OtherLICENSE