Most Relevant Information
Provider Data
| NPI Number: | 1003406547 |
| Provider Name: | JACOB FOX |
| Entity Type: | Individual |
| Taxonomy Code: | 2255A2300X |
| Specialty: | Specialist/Technologist |
| License Number: | 1314 |
Most Important Dates
| Enumeration Date: | 01/19/2021 |
| Last Updated: | 06/05/2024 |
Provider Practice Location
644 QUILLEN AVE
FOUNTAIN INN
SC
296449447
Practice Location Phone/Fax
| Phone: | 8644361883 |
| Fax: |
Provider Mailing Location
120 SANDY LN
GREENVILLE
SC
296055949
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |