MEDICARE: CRAIG PETER FOLSE M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0202X	Diagnostic Radiology Physician	MD.011396	LA
2	2085R0202X	Diagnostic Radiology Physician	19194	MS

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1073563862
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CRAIG PETER FOLSE M.D.

Provider Business Mailing Address
First Line	:	1240 RICHARDSON RD
Second Line	:
City	:	CALHOUN
State	:	LA
Zip	:	71225-9440
Country	:	US
Telephone Number	:	318-644-4401
Fax Number	:	318-644-4402

Provider Business Practice Location Address
First Line	:	1240 RICHARDSON RD
Second Line	:
City	:	CALHOUN
State	:	LA
Zip	:	71225-9440
Country	:	US
Telephone Number	:	318-644-4401
Fax Number	:	318-644-4402

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/11/2006
Last Update Date	:	03/20/2015

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