Provider Demographics
NPI:1487634234
Name:FOLZ, THOMAS J (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:J
Last Name:FOLZ
Suffix:
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:PO BOX 104240
Mailing Address - Street 2:
Mailing Address - City:JEFFERSON CITY
Mailing Address - State:MO
Mailing Address - Zip Code:65110-4240
Mailing Address - Country:US
Mailing Address - Phone:573-556-7725
Mailing Address - Fax:573-761-3596
Practice Address - Street 1:1225 W STADIUM BLVD
Practice Address - Street 2:
Practice Address - City:JEFFERSON CITY
Practice Address - State:MO
Practice Address - Zip Code:65109-6023
Practice Address - Country:US
Practice Address - Phone:573-556-7725
Practice Address - Fax:573-761-3596
Is Sole Proprietor?:No
Enumeration Date:2006-01-18
Last Update Date:2010-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO113269208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO113509OtherBCBS
MO332948OtherHEALTHLINK
MOCD6060OtherRAILROAD GROUP
MO080114883OtherRAILROAD MEDICARE
MO209660208Medicaid
MOCD6060OtherRAILROAD GROUP
MO332948OtherHEALTHLINK
MO209660208Medicaid