Provider Demographics
NPI:1225198690
Name:FOLEY MEDICAL CENTER LTD
Entity Type:Organization
Organization Name:FOLEY MEDICAL CENTER LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OF FOLEY MEDICAL CENTER
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:K
Authorized Official - Last Name:STILES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:320-968-7234
Mailing Address - Street 1:PO BOX 218
Mailing Address - Street 2:471 HWY 23
Mailing Address - City:FOLEY
Mailing Address - State:MN
Mailing Address - Zip Code:56329
Mailing Address - Country:US
Mailing Address - Phone:320-968-7234
Mailing Address - Fax:320-968-7237
Practice Address - Street 1:471 HWY 23
Practice Address - Street 2:
Practice Address - City:FOLEY
Practice Address - State:MN
Practice Address - Zip Code:56329
Practice Address - Country:US
Practice Address - Phone:320-968-7234
Practice Address - Fax:320-968-7237
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
54317F0OtherBCBS
54317F0OtherBCBS