Healthcare Provider Details

I. General information

NPI: 1225198690
Provider Name (Legal Business Name): FOLEY MEDICAL CENTER LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/08/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

471 HWY 23
FOLEY MN
56329
US

IV. Provider business mailing address

PO BOX 218 471 HWY 23
FOLEY MN
56329
US

V. Phone/Fax

Practice location:
  • Phone: 320-968-7234
  • Fax: 320-968-7237
Mailing address:
  • Phone: 320-968-7234
  • Fax: 320-968-7237

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: KEVIN K STILES
Title or Position: PRESIDENT OF FOLEY MEDICAL CENTER
Credential: MD
Phone: 320-968-7234