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NPI Code Detail

MEDICARE: KEVIN J FOLCHERT MD

MEDICARE: KEVIN J FOLCHERT MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician20197NE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1124093695
Entity Type Code : Individual
Provider Name (Legal Business Name) : KEVIN J FOLCHERT MD
Provider Business Mailing Address
First Line : 814 PIERCE ST
Second Line : SUITE 102
City : SIOUX CITY
State : IA
Zip : 51101-1058
Country : US
Telephone Number : 712-226-2600
Fax Number : 712-226-2605
Provider Business Practice Location Address
First Line : 3250 PLAZA DR
Second Line :
City : SOUTH SIOUX CITY
State : NE
Zip : 68776-3144
Country : US
Telephone Number : 402-412-4220
Fax Number : 402-494-1365
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/20/2006
Last Update Date : 03/08/2011

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