Healthcare Provider Details

I. General information

NPI: 1215986187
Provider Name (Legal Business Name): DARCY D FOLZENLOGEN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/09/2006
Last Update Date: 09/14/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 HOSPITAL DRIVE
COLUMBIA MO
65212-0001
US

IV. Provider business mailing address

PO BOX 843966
KANSAS CITY MO
64184-3966
US

V. Phone/Fax

Practice location:
  • Phone: 573-882-8788
  • Fax: 573-882-3131
Mailing address:
  • Phone: 573-882-3974
  • Fax: 573-884-0943

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number113859
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: