Provider Demographics
NPI:1528014339
Name:FOLTZ, JASON ANDREW (DO)
Entity Type:Individual
Prefix:DR
First Name:JASON
Middle Name:ANDREW
Last Name:FOLTZ
Suffix:
Gender:M
Credentials:DO
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Other - Credentials:
Mailing Address - Street 1:PO BOX 751069
Mailing Address - Street 2:ECU PHYSICIANS FAMILY MEDICINE
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28275-1069
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:101 HEART DRIVE
Practice Address - Street 2:ECU PHYSICIANS FAMILY MEDICINE CENTER
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-4300
Practice Address - Country:US
Practice Address - Phone:252-744-4611
Practice Address - Fax:252-744-2056
Is Sole Proprietor?:No
Enumeration Date:2006-05-25
Last Update Date:2024-02-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAOS013125207Q00000X
NC2010-01845207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5916388Medicaid
NC1608JOtherBCBSNC
NC2403296Medicare PIN