Provider Demographics
NPI:1235131699
Name:FOLEY, WILLIAM S JR (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:S
Last Name:FOLEY
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:251 ROSE HILL AVE
Mailing Address - Street 2:
Mailing Address - City:VERSAILLES
Mailing Address - State:KY
Mailing Address - Zip Code:40383-1223
Mailing Address - Country:US
Mailing Address - Phone:859-873-8846
Mailing Address - Fax:859-873-8846
Practice Address - Street 1:251 ROSE HILL AVE
Practice Address - Street 2:
Practice Address - City:VERSAILLES
Practice Address - State:KY
Practice Address - Zip Code:40383-1223
Practice Address - Country:US
Practice Address - Phone:859-873-8846
Practice Address - Fax:859-873-8846
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-15
Last Update Date:2014-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY15864207Q00000X, 207QA0401X
OH35.123032207QA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64158645Medicaid
1188301Medicare ID - Type Unspecified
C63290Medicare UPIN