Provider Demographics
NPI:1679063036
Name:FOXX, PETER
Entity type:Individual
Prefix:
First Name:PETER
Middle Name:
Last Name:FOXX
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8100 RAVINES EDGE CT
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43235-5426
Mailing Address - Country:US
Mailing Address - Phone:614-985-3112
Mailing Address - Fax:614-410-8827
Practice Address - Street 1:8100 RAVINES EDGE CT
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43235-5426
Practice Address - Country:US
Practice Address - Phone:614-985-3112
Practice Address - Fax:614-410-8827
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-11
Last Update Date:2018-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator