Provider Demographics
NPI:1326844234
Name:FOX, SUMMER KIRSTEN
Entity type:Individual
Prefix:
First Name:SUMMER
Middle Name:KIRSTEN
Last Name:FOX
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5336 LAUREL FLS
Mailing Address - Street 2:
Mailing Address - City:GROVETOWN
Mailing Address - State:GA
Mailing Address - Zip Code:30813-5231
Mailing Address - Country:US
Mailing Address - Phone:706-373-0028
Mailing Address - Fax:
Practice Address - Street 1:5336 LAUREL FLS
Practice Address - Street 2:
Practice Address - City:GROVETOWN
Practice Address - State:GA
Practice Address - Zip Code:30813-5231
Practice Address - Country:US
Practice Address - Phone:706-373-0028
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-21
Last Update Date:2025-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program