Provider Demographics
NPI:1952991556
Name:FOX, THOMAS J (RPH)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:J
Last Name:FOX
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2308 12TH ST
Mailing Address - Street 2:
Mailing Address - City:HARLAN
Mailing Address - State:IA
Mailing Address - Zip Code:51537-2002
Mailing Address - Country:US
Mailing Address - Phone:712-755-3823
Mailing Address - Fax:712-755-3858
Practice Address - Street 1:2308 12TH ST
Practice Address - Street 2:
Practice Address - City:HARLAN
Practice Address - State:IA
Practice Address - Zip Code:51537-2002
Practice Address - Country:US
Practice Address - Phone:712-755-3823
Practice Address - Fax:712-755-3858
Is Sole Proprietor?:No
Enumeration Date:2021-01-19
Last Update Date:2021-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA17439183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist