Provider Demographics
NPI:1972601870
Name:FOLEY, JAMES M (OD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:M
Last Name:FOLEY
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4422 MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:PITTSFIELD
Mailing Address - State:VT
Mailing Address - Zip Code:05762
Mailing Address - Country:US
Mailing Address - Phone:802-746-8083
Mailing Address - Fax:
Practice Address - Street 1:341 NORTH MAIN STREET
Practice Address - Street 2:
Practice Address - City:BARRE
Practice Address - State:VT
Practice Address - Zip Code:05641
Practice Address - Country:US
Practice Address - Phone:802-476-7932
Practice Address - Fax:802-479-5523
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2008-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT030-0000236152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT0009372Medicaid
VTVT9372Medicare PIN
VTU25232Medicare UPIN