Provider Demographics
NPI:1538370838
Name:FOX, MATTHEW (MD)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:
Last Name:FOX
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7672 MONTGOMERY RD # 237
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45236-4204
Mailing Address - Country:US
Mailing Address - Phone:513-531-1025
Mailing Address - Fax:
Practice Address - Street 1:7672 MONTGOMERY RD # 237
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45236-4204
Practice Address - Country:US
Practice Address - Phone:513-531-1025
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-25
Last Update Date:2009-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH570091152085R0202X
CT481142085R0202X
FLME1055532085R0202X
IL36.124432085R0202X
LAMD.2033842085R0202X
MA2419312085R0202X
MI43010954182085R0202X
PAMD4381882085R0202X
NJ25MA086737002085R0202X
GA635862085R0202X
DEC1-00092272085R0202X
OK273492085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology