Healthcare Provider Details

I. General information

NPI: 1326191768
Provider Name (Legal Business Name): PAUL J FOLEY III MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/19/2007
Last Update Date: 04/27/2021
Certification Date: 04/27/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

599 W STATE ST STE 302
DOYLESTOWN PA
18901-2567
US

IV. Provider business mailing address

PO BOX 829641
PHILADELPHIA PA
19182-0001
US

V. Phone/Fax

Practice location:
  • Phone: 215-230-6982
  • Fax: 215-230-6983
Mailing address:
  • Phone: 672-370-5295
  • Fax: 215-230-3725

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License NumberMD425590
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: