Provider Demographics
NPI:1083080600
Name:FOLEY FAMILY PRACTICE MANAGEMENT
Entity Type:Organization
Organization Name:FOLEY FAMILY PRACTICE MANAGEMENT
Other - Org Name:FOLEY FAMILY PRACTICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TARA
Authorized Official - Middle Name:A
Authorized Official - Last Name:WAITE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-522-7000
Mailing Address - Street 1:205 W ORANGE AVE
Mailing Address - Street 2:
Mailing Address - City:FOLEY
Mailing Address - State:AL
Mailing Address - Zip Code:36535-1905
Mailing Address - Country:US
Mailing Address - Phone:251-943-6108
Mailing Address - Fax:251-943-6108
Practice Address - Street 1:205 W ORANGE AVE
Practice Address - Street 2:
Practice Address - City:FOLEY
Practice Address - State:AL
Practice Address - Zip Code:36535-1905
Practice Address - Country:US
Practice Address - Phone:251-943-6108
Practice Address - Fax:251-943-6108
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-18
Last Update Date:2015-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care