Provider Demographics
NPI:1427092121
Name:FOX, RICHARD L (MD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:L
Last Name:FOX
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:539 NW HWY 101
Mailing Address - Street 2:SUITE A
Mailing Address - City:DEPOE BAY
Mailing Address - State:OR
Mailing Address - Zip Code:97341
Mailing Address - Country:US
Mailing Address - Phone:541-765-3265
Mailing Address - Fax:541-765-3260
Practice Address - Street 1:539 NW HWY 101
Practice Address - Street 2:SUITE A
Practice Address - City:DEPOE BAY
Practice Address - State:OR
Practice Address - Zip Code:97341
Practice Address - Country:US
Practice Address - Phone:541-765-3265
Practice Address - Fax:541-765-3260
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2013-03-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
ORMD18113207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORD43913Medicare UPIN