MEDICARE: FOLEY CLINIC CORP

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	207R00000X	Internal Medicine Physician
2	207X00000X	Orthopaedic Surgery Physician
3	208000000X	Pediatrics Physician
4	208VP0000X	Pain Medicine Physician
5	207Q00000X	Family Medicine Physician

Other Identifiers

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

General Provider Information

NPI Number	:	1629027826
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FOLEY CLINIC CORP

Provider Business Mailing Address
First Line	:	PO BOX 689022
Second Line	:
City	:	FRANKLIN
State	:	TN
Zip	:	37068-9022
Country	:	US
Telephone Number	:	615-465-7000
Fax Number	:	615-469-6564

Provider Business Practice Location Address
First Line	:	101 E 15TH AVE
Second Line	:
City	:	GULF SHORES
State	:	AL
Zip	:	36542-3501
Country	:	US
Telephone Number	:	251-968-5901
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR, PROVIDER ENROLLMENT
Name	:	KRISTINA MUSIC
Credential	:
Telephone Number	:	877-892-9815

Provider Enumeration Date	:	05/08/2006
Last Update Date	:	06/16/2025

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1568752350 — MRS. LAUREN TAYLOR BODENHAMER NP
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Directions to “FOLEY CLINIC CORP ” Practice Location

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