Provider Demographics
NPI:1194794289
Name:FOLEY, JOHN A JR (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:A
Last Name:FOLEY
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:3297 BROAD ST
Mailing Address - Street 2:PO BOX 687
Mailing Address - City:EXMORE
Mailing Address - State:VA
Mailing Address - Zip Code:23350
Mailing Address - Country:US
Mailing Address - Phone:757-442-3937
Mailing Address - Fax:757-442-5008
Practice Address - Street 1:3297 BROAD ST
Practice Address - Street 2:
Practice Address - City:EXMORE
Practice Address - State:VA
Practice Address - Zip Code:23350
Practice Address - Country:US
Practice Address - Phone:757-442-3937
Practice Address - Fax:757-442-5008
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2008-03-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101036614207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA6327079Medicaid
VA6327079Medicaid
VADG7096Medicare PIN