Provider Demographics
NPI:1447219589
Name:FOELSCH, JAMES M (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:M
Last Name:FOELSCH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 73410
Mailing Address - Street 2:
Mailing Address - City:FAIRBANKS
Mailing Address - State:AK
Mailing Address - Zip Code:99707-3410
Mailing Address - Country:US
Mailing Address - Phone:800-478-4091
Mailing Address - Fax:907-770-2341
Practice Address - Street 1:1919 LATHROP ST
Practice Address - Street 2:SUITE 220
Practice Address - City:FAIRBANKS
Practice Address - State:AK
Practice Address - Zip Code:99701-5942
Practice Address - Country:US
Practice Address - Phone:907-452-1739
Practice Address - Fax:907-452-2384
Is Sole Proprietor?:No
Enumeration Date:2006-03-18
Last Update Date:2010-08-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AK21072084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKMD2107Medicaid
E35422Medicare UPIN
AKMD2107Medicaid