John Robert Fox, MD
Individual provider Active NPI Pediatrics Physician · South Pittsburg, TN
NPI 1689779191 · NPPES record last updated Sep 17, 2008
Key facts
- NPI
- 1689779191
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- 31310 (TN)
- Practice address
- 325 South Cedar Avenue
Suite 1
South Pittsburg, TN 37380-1305 - Phone
- (423) 228-4159
- NPI assigned
- Sep 13, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 31310 | TN | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pediatric Specialists of Marion County PLLC | Pediatrics | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 31310 | TN | Yes |
Addresses
Primary practice location
325 South Cedar Avenue
Suite 1
South Pittsburg, TN 37380-1305
Mailing address
325 South Cedar Avenue
Suite 1
South Pittsburg, TN 37380-1305
Phone (423) 228-4159
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| TN0101 | Other | TN | UNITED HEALTHCARE OF RIVER VALLEY PROVIDER NUMBER |
| 1504527 | Medicaid | TN | |
| TN0101 | Other | TN | AMERICHOICE PROVIDER NUMBER |
| 4076373 | Other | TN | BCBS PROVIDER NUMBER |
Other providers in South Pittsburg, TN
- Crossroads Urgent Care PLLC
- Samantha Everhart Dutton
- Eyear Optical, Inc.
- Kristin M Flake
- Joshua Fogleman
- Tracy G Gartman
- Thomas Charles Helm
- Katie Elizabeth Henson
- Shana T Hilson
- Mandy Howard
All providers in South Pittsburg, TN · Pediatrics Physician in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 17, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.