Provider Demographics
NPI:1538258645
Name:FOX, ROBERT BURTON JR (OD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:BURTON
Last Name:FOX
Suffix:JR
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:560 KEMPSVILLE RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-3621
Mailing Address - Country:US
Mailing Address - Phone:757-410-9500
Mailing Address - Fax:757-410-9507
Practice Address - Street 1:560 KEMPSVILLE RD
Practice Address - Street 2:SUITE 100
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-3621
Practice Address - Country:US
Practice Address - Phone:757-410-9500
Practice Address - Fax:757-410-9507
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2013-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4926/T1796152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA6803800OtherCIGNA
VA415038OtherBCBS
VA1538258645Medicaid
OHU73170Medicare UPIN
OHFO0864392Medicare ID - Type Unspecified
VA6803800OtherCIGNA
VAVAA102366Medicare PIN