Healthcare Provider Details

I. General information

NPI: 1306959887
Provider Name (Legal Business Name): DR. GREG J FOLSOM, AN OPERATING DIVISION OF PROVIDENCE MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8919 PARALLEL PKWY SUITE 270
KANSAS CITY KS
66112-1636
US

IV. Provider business mailing address

8919 PARALLEL PKWY SUITE 131
KANSAS CITY KS
66112-1636
US

V. Phone/Fax

Practice location:
  • Phone: 913-788-7111
  • Fax: 913-788-3702
Mailing address:
  • Phone: 913-825-6531
  • Fax: 913-328-7011

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. JAMES T PAQUETTE
Title or Position: CEO, PROVIDENCE HEALTH
Credential:
Phone: 913-596-4000