Basic Information
Provider Information
NPI: 1346746914
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FOX
FirstName: ROCKY
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: DO
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PULMONARY AND CRITICAL CARE MEDICINE FELLOWSHIP
Address2: 9300 CAMPUS POINT DRIVE, MAIL CODE 7381
City: LA JOLLA
State: CA
PostalCode: 92037
CountryCode: US
TelephoneNumber: 8586577118
FaxNumber:  
Practice Location
Address1: SAN ANTONIO MILITARY MEDICAL CENTER, , MCHE-ZDM-M
Address2: INTERNAL MEDICINE RESIDENCY, 3551 ROGER BROOKE DR.
City: JBSA-FORT SAM HOUSTON
State: TX
PostalCode: 782344504
CountryCode: US
TelephoneNumber: 2109165910
FaxNumber: 2109162077
Other Information
ProviderEnumerationDate: 04/03/2018
LastUpdateDate: 07/09/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 06/16/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
390200000X  N Student, Health CareStudent in an Organized Health Care Education/Training Program 
208D00000X0102205889VAY Allopathic & Osteopathic PhysiciansGeneral Practice 

No ID Information.


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