Healthcare Provider Details

I. General information

NPI: 1437441201
Provider Name (Legal Business Name): FOLEY EYE CLINIC PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2011
Last Update Date: 05/11/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1570 CONCORDIA AVENUE
ST PAUL MN
55104-5338
US

IV. Provider business mailing address

2854 HIGHWAY 55 SUITE 130
EAGAN MN
55121-1447
US

V. Phone/Fax

Practice location:
  • Phone: 651-224-4930
  • Fax: 651-842-3391
Mailing address:
  • Phone: 651-224-4930
  • Fax: 651-842-3391

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number State

VIII. Authorized Official

Name: JOHN C FOLEY
Title or Position: PRESIDENT / OWNER
Credential: M.D.
Phone: 651-224-4930