Provider Demographics
NPI:1215387626
Name:FOX, DANIEL KENNETH (MD)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:KENNETH
Last Name:FOX
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:660 MASON RIDGE CENTER DR STE 300
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141-8512
Mailing Address - Country:US
Mailing Address - Phone:314-448-3791
Mailing Address - Fax:314-996-7658
Practice Address - Street 1:3023 N BALLAS RD STE 200D
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63131-2328
Practice Address - Country:US
Practice Address - Phone:314-996-7272
Practice Address - Fax:121-996-6785
Is Sole Proprietor?:No
Enumeration Date:2016-06-16
Last Update Date:2024-06-25
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Provider Licenses
StateLicense IDTaxonomies
MO2017043907207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease