Healthcare Provider Details

I. General information

NPI: 1932299492
Provider Name (Legal Business Name): JOHN A FOLEY, JR., M.D., P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/13/2006
Last Update Date: 02/01/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3297 BROAD ST.
EXMORE VA
23350
US

IV. Provider business mailing address

PO BOX 687
EXMORE VA
23350-0687
US

V. Phone/Fax

Practice location:
  • Phone: 757-442-3937
  • Fax: 757-442-5008
Mailing address:
  • Phone: 757-442-3937
  • Fax: 757-442-5008

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JOHN A FOLEY JR.
Title or Position: PRESIDENT
Credential: M.D.
Phone: 757-442-3937