Provider Demographics
NPI:1215285051
Name:FOX, LAURA ELIZABETH (PA-C)
Entity type:Individual
Prefix:MS
First Name:LAURA
Middle Name:ELIZABETH
Last Name:FOX
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Gender:F
Credentials:PA-C
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Mailing Address - Street 1:202 E EARLL DR STE 360
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85012-2677
Mailing Address - Country:US
Mailing Address - Phone:602-264-4431
Mailing Address - Fax:602-241-5109
Practice Address - Street 1:202 E EARLL DR STE 360
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85012-2677
Practice Address - Country:US
Practice Address - Phone:602-264-4431
Practice Address - Fax:602-241-5109
Is Sole Proprietor?:No
Enumeration Date:2012-08-28
Last Update Date:2012-10-29
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Provider Licenses
StateLicense IDTaxonomies
AZ5206363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant