Fox, Marie Louise

Fox, Marie Louise is an individual health care provider with primary practice located at 6101 Newport Rd Ste A, Portage MI 49002-9233. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Fox, Marie Louise can be contacted via phone (269) 382-6500.

Contact Information

Primary practice address
6101 Newport Rd Ste A Portage MI 49002-9233
Phone: (269) 382-6500
Fax: (269) 382-2286
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 4901004197 Michigan

Profile Details

NPI number 1790773646
LBN Legal business name Fox, Marie Louise
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 13th, 2005
Last updated Apr 13th, 2010 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1790773646 NPPES
Michigan Other 381734365 TAX ID
Michigan Other 4901004197 TAX ID
Michigan Other 17800 TAX ID
Michigan Other 900C947460 TAX ID
Michigan Other 2230146 TAX ID
Michigan MEDICAID 4536386 TAX ID

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