Healthcare Provider Details

I. General information

NPI: 1104952076
Provider Name (Legal Business Name): EUGENE F. FOLEY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/26/2007
Last Update Date: 11/07/2021
Certification Date: 11/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4555 ROCKY DELL RD
CROSS PLAINS WI
53528-9020
US

IV. Provider business mailing address

4555 ROCKY DELL RD
CROSS PLAINS WI
53528-9020
US

V. Phone/Fax

Practice location:
  • Phone: 608-413-0085
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208C00000X
TaxonomyColon & Rectal Surgery Physician
License Number50959
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number50959-020
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: