Provider Demographics
NPI:1972252922
Name:FOX, KEITH A (PHD)
Entity type:Individual
Prefix:DR
First Name:KEITH
Middle Name:A
Last Name:FOX
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3654 GOVERNMENT ST STE 2
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71302-3324
Mailing Address - Country:US
Mailing Address - Phone:318-446-5965
Mailing Address - Fax:
Practice Address - Street 1:3654 GOVERNMENT ST STE 2
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71302-3324
Practice Address - Country:US
Practice Address - Phone:318-446-5965
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-18
Last Update Date:2022-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral