Provider Demographics
NPI:1215986187
Name:FOLZENLOGEN, DARCY D (MD)
Entity type:Individual
Prefix:
First Name:DARCY
Middle Name:D
Last Name:FOLZENLOGEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 843966
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64184-3966
Mailing Address - Country:US
Mailing Address - Phone:573-882-3974
Mailing Address - Fax:573-884-0943
Practice Address - Street 1:1101 HOSPITAL DRIVE
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65212-0001
Practice Address - Country:US
Practice Address - Phone:573-882-8788
Practice Address - Fax:573-882-3131
Is Sole Proprietor?:No
Enumeration Date:2006-05-09
Last Update Date:2022-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO113859207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO112160OtherBLUE SHIELD/BLUE CHOICE
MO342700OtherHEALTHLINK
MO3209013OtherUNITED HEALTHCARE
MO208905109Medicaid
MO963240635Medicare PIN
MO3209013OtherUNITED HEALTHCARE
MO990003145Medicare PIN
MO029011441Medicare PIN
MO208905109Medicaid